Course Registration Form

Student Name

First NameMiddle NameLast Name

Birth Date

MonthDayYear

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student E-mail

example@example.com

Mobile Number

Cosmetology State License info

Please select your class interest

I want to pay in fullHolistic Drugless PractitionerI am a P2p Certified Hair loss Practitoner and I would like to complete the Trichology CourseI need a refresher CourseI want the financing offer

What is your lab coat size?

Do you have an NPI number for your Center/ Clinic?

Have you taken a hair loss or Trichology course before, if so where?

If yes, did you graduate or received a certification

I understand that I must be a licensed beauty professional in order to attend any educational class at P2P Certification & Training Institute. I acknowledge that my license are active in my state. I understand that if I am not licensed or non-active, I will not be accepted or can be terminated from the program . I understand that all deposits and tuition payments are NON-REFUNDABLE & NON-TRANSFERABLE unless approved by Dr. Suzette T. Robinson.

Additional Comments

My Products

Board Certified TrichologyBoard Certified Trichology ( Full Certification)

$9,997.00 Quantity

Holistic Drugless Practitioner Course Must be Board Certified Trichologist of P2p Student Alumni ONLY!!Must be Board Certified Trichologist of P2p Student Alumni ONLY!!

$597.00 Quantity

P2p Trichology RefresherAre you in need of refreshing your educational skills in Trichology? This course is for those who have taken the trichology course but desire to move forward with starting their career as a Trichologist.

$3,500.00 Quantity

P2p Class Deposit

$500.00 Quantity

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Afterpay