Enrollment Form

Have you ever used the services of Holistic/Alternative Techniques, Counseling, or Therapy
Yes
Do you have any training, skills or interest related to this field of study?
Yes
Explain
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Life Coach
Are you comfortable talking to others in a therapeutic professional setting?
Yes
Are you currently employed?
Yes
Do you want to work for...
Someone else
Do you seem to switch jobs a lot?
Yes
Did you enjoy school?
test
Did you join any school activities?
Yes
Are you good at taking directions from others?
Yes
Do you complete tasks?
Yes
Are you flexible?
Yes, No
Have you ever been convicted of a crime?
No
Do you have a drug or alcohol problem?
No
Give me two reasons why you should be admitted to this training program?
Are there any health concerns you would like to see improved through the information obtained during your eduction/training?
No
Are you currently taking any prescribed medication?
No
Entrance Examination
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Behavioral Therapist
This exam is in two parts. The first part is to determine your ability to get along with and motivate (understand) people. The Second part is an essay form to review in part, your present knowledge, understanding of the Healing Arts & Sciences and how the alternative / holistic approach to health can help individuals.
Part One
All people like to be told what to do and how to live their lives.
False
Some people are considered oppositional, that is, they will do the opposite of what they are asked to do.
True
People will change their habits only when they are ready to change.
False
One of the most important areas in therapy is to determine what motives or drives a person to act.
True
A successful way to motive someone is to find out what is important to him or her first. Then motivate to their importance, rather than your own opinion.
False
It is much easier to predict what a group of people will do rather than an individual.
False
Some people are more of an analytical nature and some are more of an emotional nature.
True
An individual’s childhood, including family structure and school experiences can have a dramatic effect later in adulthood.
True
Some people can be classified as passive and same as taking charge.
True
Communication and a sincere interest in helping others improve their quality of life are important attributes of a successful therapist.
False
Part Two
Please answer the following questions. Be thorough. Answer with as much detail as possible and use the back of this page if necessary.
Referring to your chosen career, as a Holistic Health Practitioner, Behavioral Therapist, Clinical Hypnotherapist, Life Coach, Aromatherapist, or Master Herbal Practitioner.
Agreement for Admission
In case of emergency, please notify (Name of nearest relative):
Educational Experience: List your prior Education: (including High School, College, University and other Training Programs)
Do you have a physical or learning disability?
No
Are there health concerns that would limit your ability to successfully participate in the activities of course?
No
Please attach a photo copy of your ID or DL
Max File Size 15MB
Please attach a photo copy of your Diploma or Transcript of the highest level of education completed
Max File Size 15MB
UNDERSTANDINGS
BE SURE TO READ ALL PAGES OF THIS AGREEMENT. IT IS PART OF YOUR CONTRACT WITH THE SCHOOL
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Certified Behavioral Therapist
Classes for either a Program or Classes are held on the following:
Tues, Thurs, Fri
Enrollment Agreement Period PROGRAM
Enrollment Agreement Period CLASSES

Itemization and Total Tuition Fees

Program/Class:
Registration
Non-refundable - due upon enrollment ($100)
STRF
$0.00 per $1000, for CA Residents only Non Refundable. Currently 0
Books & Materials
Included
Shipping
Shipping Fees are Non-Refundable
Tuition
OR
Down Payment
Down Payment
Total Enrollment Charges
Total Charges The Student Is Obligated To
Pay Upon Enrollment
Admin Fee
Add 10% of balance due for payment plans (non-refundable)
Deposit
Total Down Payment Charge Upon Enrollment
Total Charges For The Current Period Of Attendance
Total charges for the current period of attendance
Total Charges For Program 
Estimated total charges for the entire education program
Balance Due Payment Plan (__)x____Months
Balance (Tuition - tuition PP deposit)
Balance divided by (x)____ for amount per Month
TFC Financing-attached truth & lending part of enrollment agreement
Total Charges
Total charges student is obligated to pay upon enrollment
CHT
NOTICE
YOU MAY ASSERT AGAINST THE HOLDER OF THE PROMISSORY NOTE YOU SIGNED. IN ORDER TO FINANCE THE COST OF INSTRUCTION ALL OF THE CLAIMS AND DEFENSES THAT YOU COULD ASSERT AGAINST THIS SCHOOL, UP TO THE AMOUNT YOU HAVE ALREADY PAID UNDER THE PROMISSORY NOTE.
Placement Assistance Waiver
Program
Holistic Health Practitioner

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California Institute of the Healing Arts & Sciences

2377 Gold Meadow Way, Suite 100 Gold River, California 95670

(916) 484-1700 ~ info@californiainstitute.net

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CIHAS is an Alternative Holistic Training School offering courses in Clinical Hypnotherapist, Aromatherapist, Holistic Health Practitioner, Behavioral Therapist, Master Herbal Practitioner, Life Coach & Herbal Healing Workshops. Serving: Sacramento, Gold River, Fair Oaks, El Dorado Hills, Cameron Park, Auburn, Grass Valley, Nevada City, Chico, Northern California and all surrounding areas.

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