Level 1 Training Scholarship Application - $1,000 Tuition Assistance

Level 1 Training Scholarship Application - $1,000 Tuition Assistance
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you attended a Complimentary Consultation with Candace?*

Yes, I have.Yes, I've watched a recording of a recent Consultation.No, I haven't attended a Consultation yet.
How did you hear about this opportunity? If you were referred by a friend / student, please provide their first and last name. *
Do you have experience with or interest in other healing modalities? (ie. Meditation, Acupuncture, Breathwork, Massage Therapy, Spirituality, Yoga, Reiki) If yes, please explain.*
What is your motivation for becoming a practicing healer?*
With your $1,000 scholarship applied, the total investment for the Level One Academy is $4,300. Please note that all payments are non-refundable. To acknowledge and accept these terms, type "I AGREE" in the text box below.*
Please select a Payment Plan option:*

Pay In Full: $500 Application Fee + $3,800 USD3 Month Payment Plan: $500 Application Fee + $1,267 USD/month.6 Month Payment Plan: $500 Application Fee + $634 USD/month.
Please Note: All students will receive the Level 1 Training Course in-full, regardless of your payment plan choice. However, each student will receive their Level 1 Initiation from Ms. Silvers once their payment plan has been completed.
Please confirm your understanding that your $500 Application Fee will be processed with your completed application. Upon acceptance into the Academy, your payment plan will commence (as indicated above) and all payments are non-refundable.*

Yes, I understand.I can't make the initial payment right now. *If this is the case, your application will not process until after you've had a conversation with our financial department.

My Products*

Application Fee for The Silvers Healing Academy

$500.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please confirm your understanding that it is your responsibility to attend each class online.*

Yes, I understand and agree.I cannot make this agreement at this time.
Signature*

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