MAcCHM Registration Form SP 2025-26

Registration Form SP 2025-26

Master of Acupuncture
Student ID Number*
Student Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date

MonthDayYear
Gender
Student E-mail*
example@example.com
Mobile Number*
Please choose the subjects for registration .
Acupuncture Class Subjects

ACUP601 Basic Acupuncture TechniqueACUP606 Asian Body WorkBIOM303 Medical TerminologyBIOM401 Humane Anatomy and Physiology IBIOM404 Medical Pathology IIBIOM702 Clean Needle Techniques and Safety IssuesEAMS501 Introduction to East Asian MedicineEAMS503 Principles of East Asian Medicine IIEAMS602 East Asian Medicine Pathology IIEAMS604 East Asian Medicine Diagnosis II
Total Credits
Didactic Tuition
Clinical Internship Subjects

CLIN501 Clinical Observation ICLIN502 Clinical Observation IICLIN503 Clinical Observation IIICLIN601 Clinical Internship ICLIN603 Clinical Internship IIICLIN604 Clinical Internship IV
Total Internship Hours
Internship Tuition
Additional Fees

Application FeeRegistration FeeClinic Fee (Observation I)Clinic Fee (Observation II)Clinic Fee (Internship I)Clinic Fee(Internship III)Clinic Fee(Internship IV)I-20 Issue Fee (Student)I-20 Issue Fee (Spouse)I-20 Issue Fee (Child)Lab Coat FeeTranscript Evaluation FeeGraduation Fee
Total Tuition and Fee
Signature*

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Registration Form SP 2025-26

Please choose the subjects for registration .