DienChan Fundamentals Course – DCCP Registration

Registrant's Name *

First

Last

Date of birth *

Email *

Phone *

Address

Natural Medicine Courses Attended (if available)

Please list any relevant courses you have attended, such as acupressure, acupuncture, reflexology, or other natural medicine modalities.

Tools *

I have the 7 Basic Toolkit items (Course fee will be waived for eligible students).
I don’t have the 7 Basic Toolkit items and would like to enroll with a discounted fee of $200, which includes a free toolkit valued at CAD $310.

Course Date Interest (Check all that apply). Jan 2024 *

Weekday Morning (9:00 AM – 11:00 AM)
Weekday Afternoon (1:00 PM – 3:00 PM)
Weekday Evening (7:00 PM – 9:00 PM)
Weekend Daytime (10:00 AM – 04:00 PM)
Weekend Evening (5:00 PM – 9:00 PM)
Anytime

Please select your preferred course format *

Online (Via Zoom): Participants will attend live sessions via Zoom. In-person practice exam required on the last day. Access to our online learning platform for the course.
Offline (At our venue – To be confirmed): Participants will attend in-person sessions at our venue (location to be confirmed). In-person practice exam required on the last day. Access to our online learning platform for the course.
Hybrid (Combination of Online and Offline)
Open to either online or offline format, as per availability.

Prefer payment methods (Check all that apply). We will inform you the payment details later. *

Please input your preferred payment methods.

Agree to the Terms and Conditions *

By completing this form, I agree to the Terms and Conditions of DienChan Care Inc.

I agree to the following charge *

Stripe Credit Card *

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