Last Name:

First Name:

Middle Initial:

Social Security Number:
(if applicable)

Date of Birth:

   (Day/Month/Year)

Time of Birth:

AM or PM:

Place of Birth:

   (City, State, Country)

Address:

Apt #:

City:

State:

   Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Country:

Zip/Postal Code

Country Code:

   (if outside of USA)

Telephone:

Email:

Current Education Level:

High School Graduate:

   Yes No

Bachelor's Degree:

Master's Degree:

Doctorate Degree:

Colleges Attended:

List the school, city, state, major, degree and dates.

Official transcripts from each of the above schools are to be sent directly to Florida Vedic College and must be on file prior to start of classes. High School transcripts are not necessary for those applying to the Masters or Doctoral programs.

Please list any previous training or education in Indian Religions & Vedic Philosophy:

Are you a Physician:

Yes  No

A Chiropractor:

Yes   No

Other Medical Practicioner:

Yes   No

Are you currently a practitioner of Alernative Medicine or Naturopathy:

Yes   No

Please list your reasons for wanting to take this Ayurveda Certificate of Training Program:  

If you are taking the Ayurveda Certificate of Training Program (C.A.T.) please list if you are one of the following:

Admission Requirements:

Masters Degree in Dhanvantari Ayurveda:

Bachelor's Degree, acceptable by FVC or,
Bhaktivaibhava Degree (Vedic Degree) or,
Pass Master's Degree Program Entrance Examination

Doctorate Degree in Dhanvantari Ayurveda:

Master's Degree in Dhanvantari Ayurveda or,
Master's Degree, acceptable by FVC or,
Bhaktivedanta Degree (Vedic Degree) or,
Enrolled in Combined Master's/Doctorate Degree Ayurveda Program

Tuition Costs:

Application Fee:  
(mandatory for all students)  

$60.00

Entrance Examination:  
(if required)  

$75.00

Dhanvantari Ayurveda Certificate of Training:  
(Non-Degree Program)  

$1,980.00

Dhanvantari Ayurveda Associates Degree Program:  

$5,500.00

Dhanvantari Ayurveda & Aromatherapy Associates  
Degree Program:  

$5,500.00

Only the application fee must be submitted with this application however you may pre-pay if you so choose. I understand that if my application is accepted an invoice will be sent for 30% of my total tuition, which will be immediately due Florida Vedic College. The remaining portion of my tuition must be paid PRIOR to the commencement of the course. As soon as the complete payment has been received by the College you will receive confirmation of your acceptance to the course/degree program. Your failure to complete your payment may result in losing your position in the course. If an acceptable amount of students have not enrolled into the program the College will inform you in writing and refund all payments (less application fee) received by the College. If one or more of the courses have been rescheduled you will be informed in writing. Your fees are automatically transferred to the next scheduled intensive course. If participant wants to cancel his application, cancellation notice must be received in writing two weeks prior to course commencement date. During the duration of the course, a student can withdraw from the course/program however, no refund will be given. If a student for any reason cannot complete the course, they may continue the missed courses during the next scheduled class session by obtaining the approval from the College. All participants must adhere to the instructions of the teachers and representatives of the Florida Vedic College.

Candidates who fail their Final Examination, can retake the Final Examination at a future date agreeable to the College. All retake exams are subject to an administrative fee. If any points of this contract become invalid, all remaining portions of the contract will remain as valid. In the event of litigation the student agrees to have the College appoint an arbitrator, at the expense of the student, to have the final decision on all matters.

Payment Method:

   Please Select Personal Check Business Check Mastercard American Express VISA

For Credit Card Payment Only

Account Holder Name:

Account Number:

Expiration Date:

Address on Card:

If paying by personal or business check please use the following diagram as a guide:

Bank Information:

Bank Name:

Address:

City, State & Zip Code

Phone Number

Check Information:

Account Holder Name:

Account Number:

Check Date:

Check Number:

Check Amount:

Transit Code:

Routing Number:

By choosing "Submit Application" you authorize Florida Vedic College to draft your bank account for the amount shown on this form. You acknowledge that you are the owner or authorized signer on the account information entered in this form. Your order will be processed through your local bank as a normal check, and your account will never be accessed electronically. After you have entered the information, there is no need to send the check. Simply write the ordering information in your checkbook, just as if you had sent it in.

NOTE: All NSF returned checks will be subject to a $25.00 processing fee.

To Authorize Please Type "I Agree" Here: