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Enrolllment is Open
Student Application
Please fill out the application information below to enroll in the Health and Wellness training course
Student Application Form
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Select the date
December 13, 2021 Monday, Tuesday,and Wednesday (Time 4-8:30 P.M. MST) 6-week program
January 6, 2022 Thursday, Friday, and Saturday (Time: Thursday and Friday 4:00 P.M. -8:30 P.M. & Saturday: 8:00 A.M. -12:30 P.M. ) 6-Week Program
Hold My Seat (Deposit)
Personal Details
Professional Details
Please select one
Physician
Nurse Practitioner
Physical Therapist
Chiropractor
Dietitian
Nutritionist
Health Coach
Personal Trainer
none
Education
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High School
GED
Associate
BS/BA
Masters
PHD
MD/DO
Other
Credentials
I agree to the Nutrition Factors Terms and Conditions, Business Associate Agreement (BAA) and Affiliate Program Agreement *
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