Ontario Homeopathic Association

ONTARIO HOMEOPATHIC ASSOCIATION

1043 Bloor Street West, Suite 205, Toronto, Ontario, Canada M6H 1M4

PROFESSIONAL MEMBERSHIP APPLICATION

Application for registration as (check one):    HD    HP

NAME:

ADDRESS:
CITY: 
PROVINCE:

POSTAL CODE:
TEL:  
FAX:

E-MAIL:

Educational History (including years attended)               

Degree/Diploma/Certificate

   
   
   
   
   


FOR GRADUATES OF NON-ACCREDITED SCHOOLS
The following must be submitted:
  Resumé
  Proof of Canadian Citizenship or Landed Immigrant Status
 Copies of Educational Certificates/Diplomas/Degrees
  Transcripts Issued Directly by Educational Institution(s)
  Course outline/College prospectus/Calendars, etc.
  2 Letters of Reference from Professionals. (Please include telephone 
      numbers for references).
  $100.00 (CDN) non-refundable application fee.

FOR GRADUATES OF ACCREDITED SCHOOLS
The following must be submitted:
  Transcripts Issued Directly by Educational Institution(s) and
  $150.00 (CDN) for first year annual dues (if graduated within last year), or
  $275.00 (CDN) for first year annual dues (if graduated more than one year ago)

 Note: An application package will be reviewed once all the above have been submitted.

Signature                                                                                   Date:

 FOR OFFICE USE ONLY

 Comments:

 Date:

    APPROVED    DENIED    UPGRADE REQUIRED

 Registration No.: