Registration Form
First name : _______________________________________________________ Name : ____________________________________________________________
Address : _________________________________________________________
Postal code :__________________
City : ______________________________________________________________
Home Tel. : ______________________________________
Cell : ____________________________________________
Email : ___________________________________________________________________________________________________________________________________
Profession : ______________________________________________________
Date of birth : ____________________________________________________
Name of contact person in case of emergency : ________________________________________
Contact Phone no : ______________________
Training in naturopathy for a duration of 4 years (3 000 hours) given between September and June for the amount of $12,000.
Fees for school supply, identification outputs and internship for the 3rd year are to be expected (approximately $300, prices
subject to change).
75$
Non-refundable file creation fee
Payment method
Payable in 24 installments of $500. The payment amount is equal to the contract amount divided by, more or
less, the number of months of the contract. The first payment is due at the beginning of classes and thereafter
once a month payable by direct debit on the 15th of each month. (September, October, November, December,
February, March, April and May).
CNCL, 7887, boulevard St-Laurent, Montréal (Québec) H2R 1X1
514 389-3026
Conditions
1. The rate at the time of signature of the contract will be valid for the duration of the contract of each course.
The rate can be subject to change at each session for any new course.
2. The payment amount is equal to the contract amount divided by the number of months of the contract period.
The first payment is due at the beginning of classes and thereafter, once per month, payable by direct debit.
However, if the course is offered within a period of one month, then 2 payments will be payable as follows:
50% of the contract value at the beginning of the course and 50% at half term.
3. Clause required under the Consumer Protection Act (SSA contract involving sequential performance).
The consumer may cancel this contract at any time by sending the attached “Resiliation form” or another
notice in writing to that effect to the merchant. The contract is canceled, without further formality, upon
the sending of the form or notice. If the consumer cancels this contract before the merchant has begun to
perform his principal obligation, the consumer has no charge or penalty to pay. If the consumer cancels the
contract after the merchant has begun to perform his principal obligation, the consumer must pay only:
a) the price of the services received, calculated at the rate stipulated in the contract; and
b) the lower of the following two amounts: either $ 50 or a sum representing not more than 10% of the price
of the services that were not received. The merchant must pay the money he owes the consumer within 10
days following the cancellation of the contract. It would be in the interest of the consumer to refer to section
190 of the Consumer Protection Act (IRQ, c. P-140.1) and, if necessary, to contact the Office of Consumer
Protection.
4. J’accepte de prendre à ma seule charge tout risque à ma personne ou à un tiers dont je suis responsable ou qui
par mon action aurait été laisé.
5. The Parties agreed to domicile in the judicial district of Montreal for legal purposes of this contract.
6. I have read the contract, especially regarding financial conditions and agree to comply with regulations and
policies. I understand that any derogation from on my part may invalidate my registration
Signed at _________________________________ on _________________
___________________________________________________________________
Student
___________________________________________________________________
CNCL
__________________________________________________________________
Witness
What you must provide, with the registration form:
•
•
•
•
Curriculum Vitae
Photo (passport size)
Photocopy of your last school diploma
Cheque or money order to the amount of $75.00 (non refundable) payable to CNCL.
CNCL, 7887, boulevard St-Laurent, Montréal (Québec) H2R 1X1
514 389-3026
Direct debit
autorisation form
This form authorises the CNCL to make payments by debiting money directly from your account
Student Information
First name :_______________________________________________________
Name : ____________________________________________________________
Address : _________________________________________________________
City : ______________________________________________________________
Province : ________________________________________________________
Postal code : ______________________________________________________
Email address : __________________________________________________________________________________________________________________________
Information on financial institution
Please include a “VOID” cheque that shows the name and address of student
Name of financial institution: __________________________________________________________________________________________________________
Address : _________________________________________________________
This autorisation is used for (please check one) :
City : _____________________________________________________________
Personnal
Professionnal
Information on bank account
Branch number:
Bank number:
Account number:
___ ___ ___ ___ ___
___ ___ ___
___ ___ ___ ___ ___ ___ ___
5 numbers
3 numbers
7 numbers
I hereby authorise the CNCL (beneficiary) to debit from my account at the above mention institution, the amount indicated in a
previously signed contract.
Reason for debit (PA) : Naturopathy Course
___________________________________________________________________
Authorised signature
Please send your documents to the following address:
Date of first debit : _________________
__________________________________________________________
Date
Clinique l’Aube / CNCL
7887, boulevard St-Laurent
Montréal (Québec) H2R 1X1
CNCL, 7887, boulevard St-Laurent, Montréal (Québec) H2R 1X1
514 389-3026
Resiliation Form
Form dispatch date: _________________________
Under the article 193 of the Consumer Protection Act, I terminate the current contract concluded on
Agreed on __________________________________________________ at _____________________________________________________________
____________________________________________________________________
Name of student
___________________________________________________________________
Student’s Signature
_________________________________________________________________________________________________________________________________________
Address
__________________________________________________________________
Witness
CNCL, 7887, boulevard St-Laurent, Montréal (Québec) H2R 1X1
514 389-3026