Register for the Ayurveda in Nepal Clinical Program

Clinical Program Registraion Form

If you wish to apply for the 2020 Ayurveda in Nepal Clinical Program, please complete and submit the following form along with your deposit.

Full Name*
E-mail*
Address:*
Phone:*
-

Answer the following questions:

1. Please describe any health issues, disabilities, or special needs you have.
2. How would you characterize your experience and training in Ayurveda?*
3. Do you have much experience traveling or living in a developing country such as Nepal?*

Registration, payments and refund policy

To secure your spot please submit a deposit of USD $500. After clicking ‘submit’, you will be taken to PayPal to complete the payment, and PayPal will issue you a receipt by email.

By submitting this form and your deposit, you agree to participate in the Ayurveda in Nepal program, upon approval of your application, held in Kathmandu, Nepal, from February 3rd to March 6, 2019. By submitting your deposit you agree to pay the balance (USD $2700) by December 1, 2019. If you decide that you cannot join us you must ask for a refund on your deposit before November 1, 2019. If we do not receive such a request, by email, telephone (1.778.896.8894), or fax (1.866.703.2792), you will forfeit your deposit.

After November 1, 2019, all payments are non-refundable. If you submit your deposit and there are no more spots available, your deposit will be returned to you.

Deposit ($500):*
 $