Application for Admission to Advanced Program

424 E Simpson St., Unit A
Lafayette, CO 80026
720-406-8609
apply@clinicalherbalism.com

There is a $50 application fee that is non-refundable.

Legal Name(Required)

First Last

Name you go by:

First Last

Local Address(Required)

Street Address City State ZIP Code

Permanent Address, if different

Street Address City State ZIP Code

Phone(Required)

Email(Required)

What year and Fundamentals Program (Day/Eve) did you complete at CSCH?(Required)

What Program Are Applying For(Required)

Advanced DAY

Advanced EVENING

How did you hear about CSCH?

Required (Submit with this application form.)

Please write and attach a one-page essay describing why you want to attend the Advanced Herbalism Certification Program at CSCH.

Upload Documents(Required)

Drop files here or

Max. file size: 50 MB, Max. files: 4.

To sign type your name below

By entering your name above, you officially apply to the Colorado School of Clinical Herbalism

Date(Required)

Application Fee

Price:

Credit Card(Required)

American Express

Discover

MasterCard

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Card Number

Expiration Date

Security Code Cardholder Name

Billing Address(Required)

Street Address City State ZIP Code

This field is for validation purposes and should be left unchanged.