Merrithew Application -

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Name *

Email Address *

Phone *

Street Address *

City

ZIP / Postal Code

Country

Select Location and Course *

Advanced/ICCB Course Applications: *

Space is limited and applications will be processed on a first come-first-served basis.
Space will ONLY be reserved upon the receipt of application and a deposit of the course fee.
Fees for courses and workshops may not include required course materials, applicable taxes or exam fees.
Prices are subject to change without notice.
For full details on cancellation and change policies contact the training facility.
Applicants under the age of 18 are subject to registration approval by the Senior Program Director, Toronto Corporate Training Center.
Some courses have prerequisites. Additional information may be required once application is received,
i.e. a detailed resumé / CV outlining education and experience and two letters of references.

Relevant Experience *

Relevant Education *

Describe anatomy education *

Personal Information *

Why did you choose Merrithew?

If the student cancels their workshop or course enrollment less than four weeks prior to the start date of the workshop or course, there will be no refund of monies paid. Deposit is non refundable.

Certify your information *I certify that the information provided on this application is accurate.I understand that failure to provide accurate information may result in my removal from the certification program.

I understand I am required to attend all hours *Yes

Non Refundable Deposit *I understand and agree that once my application is accepted, the deposit is strictly non-refundable. I further understand that if I defer my course place for any reason, a new deposit will be required to secure a place on a future course.

Signature *