Application for Online Fundamentals Program

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

Legal Name(Required)

First Last

Preferred Name:

First Last

Address(Required)

Street Address City State ZIP Code

Mailing Address, if different

Street Address City State ZIP Code

Phone(Required)

Email(Required)

Are you at least 18 years of age?(Required)

Yes

I confirm I have access to the following technologies to take the program:(Required)

A reliable internet connection

A computer (PC, Mac, or tablet)

A webcam

I confirm I have basic computer skills like sending emails, using a web browser, and working with common file formats like PDFs:(Required)

Yes

Do you have any limitations which we should be aware of to accommodate your needs in the classroom?(Required)

Yes

Note, we do not need details on this application. We will discuss options during pre-enrollment.

How did you hear about CSCH?

Required Documentation (Please submit all 3 with this application form.)

A resume of your previous employment and education.
Proof of a high school education or college attendance (e.g., copy of diploma, completed transcript, GED).
A 1-2 page essay describing why you want to attend this school and how you think the education fits with your calling/life-vision. Include any previous herbal studies/experience.

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Application for Online Fundamentals