Application for Admission
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Personal Information (please print)
Name: ________________ _________________ _________________________
Address: ___________________________________________________
___________________________________________________
Telephone: (_____) _____-__________
Social Security Number (student ID): ______________ Birthdate: _______
Current Occupation: _____________________
Current Employer: ______________________
Academic HistoryDegree Earned: __________________________________________________
Name of Institution: ______________________________________________
Objective (check program of study desired)Homeotherapeutics _______ Bio-Energetics ______ Acupuncture _____
Instructions
Date__________ Signature______________________________________
The Institute of Natural Sciences is an equal opportunity and affirmative action
institution, committed to compliance with federal laws prohibiting discrimination.
Discrimination on the basis of race, sex, color, religion, national origin, age, height,
weight, marital status or handicap is prohibited.
All tuition and fees paid by the applicant shall be refunded if the application is
rejected by INHS before enrollment. All tuition and fees paid by the applicant shall be
refunded if requested within three business days after signing a contract with the school.
All refunds shall be returned within 30 days. INHS may retain the application fee of
$ 25.00 if the application in denied.