Application Form - Ayurveda Foundation

Name: *

Please enter your full name

Name on certificate (if different):

Your name as you'd prefer it to appear on any certificates of completion we issue. If the same as your full name, leave blank

Phone number: *

Either cell phone, home or workphone - list the phone you would like us to call, please

Email: *

The email that will be used for all communication and Virtual Campus Access

Preferred method of contact: *

I would like to be contacted by phone

I would like to be contacted by email

Other:

Please select how you would prefer to be contacted

Driver's license number:

Optional

Address
Where you would like the Enrollment Packet and Course Materials sent:

Country:

Previous Education and Experience:

Please choose previous education or current profession. Please note that we can transfer some of these hours in our AHE programs.

Course you are interested in applying for: *

Block 1 Foundation Module - 100 Hrs

Sanskrit Fundamentals (50 Hrs)

Ayurveda Workshops and short Programs

Other:

Please select the course you are interested in

Preferred method of payment: *

I would like to pay the Block 1 fees in advance for a discount

I would like to pay the Block 1 fees in monthly installments of $210

I would like to pay in advance

I would like to just submit my application at this time and will make payment arrangements later

Other:

Do you have a high school diploma?: *

Yes

No

Highest Education Completed: *

What is your aim and objective in studying Ayurveda?:

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.

Agreement - please read carefully and indicate whether you agree or disagree: *

By agreeing to this, I understand that if I am selected and choose flexible payment options, I may need to submit my credit card information in advance (by phone or website), and my credit card will be charged on the first day of enrollment, by the 15th of every month, as well as the last day of enrollment, whichever comes first. The first and last installments are payable together in advance. There are no refunds for the flexible payment option plan. To unenroll, one month notice is required.

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 the knowledge of herbs, panchakarma or nutrition I may learn is not recognized by FDA.

I understand that I must complete the Block 1 course and graduate with 65% scores minimum, before I move on to Ayurveda Wellness Practitioner or 50% minimum for Ayurveda Health Educator Program.

I understand that the college is not responsible for providing me job opportunities after the course.

I understand that this is an online, virtual course with no physical classes. The college does not accept any federal aid, nor does it give out any scholarships

I agree

I don't agree

E-Signature: *

Please sign this application by entering your initials here