| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Password must contain the following:
  • 12 Characters
  • 1 Uppercase letter
  • 1 Lowercase letter
  • 1 Number
  • 1 Special character

Page 1





hidden


You can change your mind later!





For example, if you and a sibling use the same email address, your accounts may become combined and cause registration delays





Phone Number - Domestic



Phone Number - Non Domestic



Phone Number - Admin




Other Info


Page 2

Academic, Criminal, Military Background





TAA-eligible: You may be TAA-eligible if you are a member of a group of workers who lost their jobs or experienced a reduction in wages as a result of foreign trade. In order to be eligible, a petition must have been filed with the US Department of Labor by or on behalf of your group and the Department must grant the petition and certify your worker group is eligible.
English proficiency



An advisor may contact you regarding your English proficiency
Other Info




Special Education Licensure







Education
Complete for all undergraduate, graduate or professional schools attended. 





Educational Details



Personal statement
In 500 words or less, describe why you would like to pursue a Certificate in Integrative Healthcare.  Please include your future plans and how this Certificate might contribute.
Please explain what interests you in studying Integrative Health and Wellness Coaching and how this fits into your career goals.
Why do you want to enroll in this program?