Glory to God
DOCTOR OF HOMOEOPATHIC MEDICAL SCIENCE (DMS)
PROGRAM (Four-Year Full-Time)
Last Name_______________________________ First Name ___________________ Initials ___ ___
Birth Name or Other Names Used: ______________________________________________________
Address: _________________________________________ City: __________________________
Province: ________________________ Postal Code: _____________ Country ________________
Home Telephone________________ Business: _________________ Message: ________________
Fax _________________________ Email: _____________________________________________
Date of Birth ____________________ Sex: ___ M ___ F
Please return your application package with:
1. Completed application form signed and dated.
2. Resume (including relevant experience, two references, memberships and personal interests)
3. Transcript of Academic courses completed.
4. Sponsor form attached: Yes____ No ____ Application in process _____
5. Arrangements for a Preliminary Interview will be scheduled. ________________________
REGISTRATION & TUITION:
PAYMENT SCHEDULE: First Year Classes commence September 4, 2002.
Registration Fee: $ 550.00 is due with Application ($50.00 non refundable deposit)
First semester payment: $3,500.00 is due on or before August 1st, 2002
Second semester payment: $3,500.00 is due on or before December 6th, 2002
** GST will be added to all prices. Books and supplies extra.
METHOD OF PAYMENT: Bank Draft or Certified Cheque payable to: Dr. Nielsen's Homoeopathic Medical Education and Research Centre Inc. (or DNHMERCI)
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