Application for Admission to Advanced Program

424 E Simpson St., Unit A
Lafayette, CO 80026
info@clinicalherbalism.com

Name

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Legal Name(Required)

First Last

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First Last

Local Address(Required)

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Street Address City State ZIP Code

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What month and year did you graduate from the Fundamentals Program?(Required)

Program you are applying for:(Required)

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.

Please sign and upload documents below.

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By entering your name above, you have officially applied to the CSCH Advanced Program. We will be in touch with you within a week from receipt of your application.

Date(Required)

Application for Admission to Advanced Program

Please sign and upload documents below.

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