How to Apply...
Application Deadline:
This program is in high demand. Enrolment is
limited. Please submit your application as soon as possible in order to avoid
disappointment.
Submit:
Applications
without the application fee will not be processed.
Interview
Process
Once you have completed the
application procedure (all documents received), we will arrange
an interview.
Notification of
Status
You will be notified within 30
days of the interview as to your acceptance into the program.
Upon acceptance, you will be required to sign an Application for
Enrolment form, to confirm your tuition payment plan, and to
submit a $100.00 + 7% gst non-refundable deposit.
Application Form for 2006/2009
Shiatsu School of Canada 547
College St. Toronto, Ontario M6G 1A9
Telephone: (416) 323-1818 or Toll free: (800) 263-1703
(USA & Canada only)
Personal Data: (Please Print)
Name:
________________________________________ /
________________________ / ____
(last) (first)
(initial)
date
of birth: _____ / _____ / _____
age:
_____
S.I.N. _______ / _______ / _______
day mth
yr
address: _________________________________________________________________
street
__________________________________ _______________________________
___________________
city
province
Postal Code
Email address: _____________________________________________
phone:
(Business) ____________________________ (home)
_______________________________
NEXT OF KIN: ___________________________________ relationship:
_______________________
ADDRESS:
____________________________________________________________________________
_____________________________________________________________________________________
FAMILY PHYSICIAN:
____________________________________________________________________
name
______________________________________________________________________________________
address
Illnesses Within the Past Year:
___________ from _______
to _______
PRESENT OCCUPATION:
_____________________________________________________________________________________
Company Name / Location /
Phone
________________________________________________________________
Position/Title
Duration
PAST WORK EXPERIENCE:
_____________________________________________________________________________________
Company Name / Location /
Phone
________________________________________________________________
Position/Title
Duration
POST- SECONDARY EDUCATIONAL:
School Name /
Location
Program / Course
Length of Study Year Graduated
____________________________________
____________________ ______________ _____________
____________________________________
____________________ ______________ _____________
TUITION PAYMENT PLANS:
I plan to pay: (check one)
In Full and Receive a 10%
Discount: $12,500 + gst Yes ____ No ____
In Installments: $12,500 + gst
Yes___ No ____
By Monthly Plan: $12,500 +
gst Yes___ No____
Please see calendar for further details.
Note: Payments made by cash,
certified cheque or money order, and in Canadian funds only.
There is a late charge
of $10 per day ($50.00 per week), on overdue accounts.
DOCUMENTATION
REQUIRED:
The following documents must accompany your application. Check if
included in your application. If not included, indicate date it will be
available.
______ 1. Official transcript (courses and marks) of relevant
training-must be original copies
______ 2. Medical form (use attached form)
______ 3. $10 application fee
NOTE: The school reserves the
right to cancel the acupuncture program if there is insufficient
enrolment. Should the program be cancelled, the applicant will receive a
complete refund for their registration fees and/or tuition.
