School / College & Workshop Request Form

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Schools/ colleges/ institutuions/ worshops facilitators can have their details listed:
$100.00 per modality for 12 months registration.

Please fill in the form and click the SUBMIT button below to apply. If successful an electronic Invoice will be emailed to your email address. Please print the invoice and include it with your payment and copies of qualifications when posting them.

HOLISTIC MODALITY DIRECTORY SCHOOLS, COLLEGES & COURSE WORKSHOP FACILITATOR’S INDEX REGISTRATION FORM

Fields marked with a * must be filled in

School or College Name: *
Course / Workshop Facilitator's Name: *
Suburb(s): *
Full Address (optional):
Modalities you provide education in that you wish to be listed: *
Names of Practitioners running the courses (for our records only): *
Contact Number(s): *
Web Address (optional):
Email Address: *

In filling out and submitting this form you are also agreeing to the following understandings:
1/ All information submitted is true and
2/ All qualifications of the Practitioners running the courses that are to be forwarded with payment have been obtained by those people listed and
3/ That you work with the highest intent within your nominated modality and not work or teach the modality in a manner that brings the modality and therefore its other Practitioner’s into disrepute and
4/ That the Authors of the Website have the final determination as to whether these details are displayed on the website

If you wish to email your request instead, please follow the above requirements and email to: schooldirectorylisting@equinoxholisticservices.com

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