APPLICATION FOR CONTINUING EDUCATION COURSE
FUNCTIONAL EVALUATION AND MOBILIZATION OF THE FOOT

Approved and Regulated by the Colorado Department of Higher Education, Private Occupational School Board
Just for Health School of Reflexology & Healing Arts, #P00116, is approved
as a provider of Continuing Education by the American Reflexology Certification Board (ARCB).

Old Hampden Holistic Center, 3501 South Corona St., #1, Englewood, CO 80113

email: justforhealth7@gmail.com
( if your email bounces .... leave your message at: 303-320-4367. . . and we'll get back to you!
www.justforhealth.net

Just for Health School of Reflexology & Healing Arts
Name of Course you're signing up for:
Course Start Date:
First Name: Last Name: Middle Name:
Birthday: Age: Place of Birth:
Address: City: State: Zip:
Home Phone: Work Phone:
Cell Phone: Email:
Educational Experience: Year graduated High School:

Deposit: $50. Will be credited towards class. Balance of $170 due on first day. In event of cancellation of course by instructor, deposit will be refunded.

Payment Methods:

Check: Make out to “ Just for Health” and write course name on check.
Fill out application and mail along with check to:
Just For Health, 3501 S. Corona St., #1, Englewood, CO. 80113

For PayPal Payment: 1.) Use the 'PayPal' button provided on the web application.
2.) Print the application out, fill it in and mail it to the above address.

An Enrollment Agreement required by the state of CO needs to be signed prior to class.