Full Name: ____________________________________________________________________ Present Home Address____________________________________________________________
State / Country_________________________________________Zip______________________
Telephone (__)______________Date of Birth ________________Birth Place________________
Social Security Number_________________

I hereby register for the English Pre-medical Naturopathy program [ ]
I hereby register for the English Doctor of Naturopathy program. ...[ ]
The highest level of education or certification I already have is: ______________________________________________________________________________
Please attach photocopies or other evidence of your certificates. (Not the originals).
I have chosen the [ ] AUTOMATIC PAYMENT PLAN; [ ] QUARTERLY PAYMENT PLAN
THE AUTOMATIC PAYMENT PLAN requires an initial payment of $1,200.00 (can be paid in two parts), ($850.00 for the Pre-Med program). The balance will be paid in one year. Please select the minimum monthly instalment convenient for you [ ] $200.00; [ ] $175.00; [ ] $ other.
THE QUARTERLY OR INDEPENDENT PAYMENT PLAN requires an initial deposit of 40%. The balance must be paid in one year, in monthly or quarterly instalments.
My initial down payment is __________(Must be in U.S. currency). Please use an international check or money order if you live outside the U.S.A., payable to SUMNAH (Sunny Mountain School of Natural Healing). You must also process this check at an American bank, otherwise processing will be greatly lengthened and complicated.

A photograph of yourself to be kept by the school (optional) and a $165.00 US ($195.00 US for overseas students) non-refundable registration, book mailing and processing fee must accompany this registration form. (Again, use an international check or money order processed at an American bank if you live outside the U.S.A.).
How or through whom did you learn of our school's Naturopathic program?
I have carefully read this form, understand the conditions of this program and accept its terms.

Signature____________________________________ Date_______________