Application Form

Application Form for online courses in Ayurveda and Yoga

Complete this application form. Make sure your contact information is correct, including your mailing address. Completing this application form does not obligate you in any way.
Once we receive your application, we'll contact you within 4 business days.

Please enter your full legal name. We'll use this for mailing (via US Postal Service) and for agreements. If you prefer to have a different name on certificates of completion, you may enter that below.
Your name as you'd prefer it to appear on any certificates of completion we issue. If the same as your full name as entered above, leave blank
Either cell phone, home or workphone - list the phone you would like us to call, please
The email that will be used for all communication and Virtual Campus Access. Please ensure this is entered correctly.
Date of birth (mm/dd/yyyy)
Previous degrees, certificates and/or college credits which may be applicable.
Please select the course category you are interested in applying for
Please select the preferred type of payment to use.
Please note that we accept only 15 candidates for advanced courses. Your answer can help you get priority in a waiting list. This is not applicable to the Foundation courses.

I understand that Ayurveda is a complementary health system, not meant to cure, diagnose or treat any disease. All the material provided in this course is for informational purposes and is not recognized by the FDA.

I understand that checking "I agree" and entering my initials below constitutes acceptance of an agreement.

Please sign this application by entering your initials here