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SECURE ENROLMENT FORM

Please enter your personal information:

Your Name - EXACTLY as you want it on your certificate: 

First Name      Last Name   

 

Your Name - As you want it on your name badge if you are attending the live class:

First Name      Last Name   

Company

Referred by :

Mailing address:

Street :

City:

Province:

    Postal code:  

Business Phone:  Ext:

Fax:   Home Phone:   Cell Phone: 

E-mail Address:

Degree/s Held:

 

Designations or certifications

 

License/s:

 

     

* Have you ever been convicted of a Criminal Offence for which you have not been granted a pardon?
NO  YES

* Have you ever been disciplined or had any restrictions placed on any professional licence that you hold by any Regulatory Body or Association?   
NO    
YES

* A positive answer to either of the above does not mean that you may not apply but be prepared for a delay in your registration while we investigate your circumstances.  

Questions? Type anything you have a question about here and we will get back to you.

Tuition Fees:
The classroom program tuition fee $995.00 + TAX
The distance learning program tuition fee $1,095 + TAX
All methods include a comprehensive study guide and your first-year EPC membership is waived.
Participants must complete and pass a written examination at an authorized testing centre before receiving the EPC designation.

Please select the city where you will attend the Live class:

Please select a Payment Plan for your program:  

A $25.00 Administration Fee is added to the cost for all Students that wish to take advantage of our Instalment Payment Option

Option 1 - Full Payment

Live exam prep class $995.00 + TAX

Distance learning $1,095 + TAX

Option 2 - Instalment Plan Available only for the Live class option

Live Class
$995.00 + $25.00 Administration Fee + TAX
 4 equal payments

Please select your desired method of payment:

We accept Visa or MasterCard only for Credit Card Payment


Credit card information 


* Card Number            Expiry Date            

CVV2#    (3 Digit Code on the back of your Credit Card)

* PLEASE LEAVE A SPACE BETWEEN THE NUMBERS  EXAMPLE - 5555 4444 3333 0000
 

Name on card:

 

For Payments made by Cheque 
Make cheques payable to - CIEPS   

Mail cheque/s to:

Canadian Initiative for Elder Planning Studies
4438 Ontario Street, Suite 203
Beamsville, ON  L0R 1B5

Note - Your designation will be granted when you have successfully passed the exam and your tuition is paid in full.

Type 1234 in the box to the right then click Submit Form:  
   

   
 


EPIC CONFERENCE 2014 | INTRODUCTION | ELDER FACTS | PROGRAM CURRICULUM
BENEFIT TO YOU | VERIFIED CE CREDITS | TUITION | FAQ'S | LIVE CLASS SCHEDULE
DISTANCE LEARNING | GRADUATE COMMENTS | EPC MEMBERSHIP | CODE OF ETHICS
MEET THE FACULTY MEMBERS | COMPLAINTS AND COMPLIANCE | OUR PARTNERS
MEDIA| MEMBER UPDATE | MEMBERSHIP RENEWAL | CONTACT US

Canadian Initiative for Elder Planning Studies Inc.
203-4438 Ontario Street

Beamsville, ON L0R1B5

Toll Free Phone 866 833-8606  Toll Free Fax 866 209-5111
 

This web site Copyright 2018 Canadian Initiative for Elder Planning Studies










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