MAcCHM Registration Form FA 2025-26

Registration Form FA 2025-26

Master of Acupuncture with Chinese Herbal Medicine
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

ACUP501 Introduction to Meridian TheoryACUP503 Meridian Theory and Point Location IIBIOL402 Human Anatomy and Physiology IIBIOM403 Medical Pathology IEAMS502 Principles of East Asian Medicine IEAMS601 East Asian Medicine Pathology IEAMS603 East Asian Medicine Diagnosis I
Total Credits
Didactic Tuition
Clinical Internship Subjects

CLIN501 Clinical Observation ICLIN502 Clinical Observation IICLIN601 Clinical Internship ICLIN602 Clinical Internship IICLIN603 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 II)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*

Powered by Jotform SignClear
HANBIT UNIVERSITY respects the right to privacy of its students and is committed to safety the personal information of each student.
Should be Empty: