Student Registration Form

Royal Canadian College of Osteopathy & Alternative Medicine

You Have two Options to fill the registration form:

1. Download the PDF file and fill it up and send it to us
2. Fill up the from Below and go step by step

Download The Registration Form here

Full Name

Upload your filled form here

Full Name

Date of Birth

Gender

Address

City

State/Province

Postal Code

Phone Number

Emergency Contact Name

Emergency Contact Phone Number

Relationship to Emergency Contact

Program Enrolling In

With Health Background Without Health Background

Start Date

March 2025 September 2025

Preferred Payment Plan

Full Payment Monthly Payment Custom Plan

Do you have a healthcare background?

Yes No

Education History (Up to 3 Diplomas)

Diploma 1

Institution Name

Diploma/Certificate Earned

Year of Graduation

Diploma 2

Institution Name

Diploma/Certificate Earned

Year of Graduation

Diploma 3

Institution Name

Diploma/Certificate Earned

Year of Graduation

English Proficiency

(For non-native English speakers only)

Is English Your First Language?

Yes No (If No, please provide proof of English proficiency)

By signing this form, I acknowledge that I have read and understood the policies and terms of enrollment, including the Privacy Policy, No Refund Policy, and Attendance Requirements. I agree to abide by all rules and regulations set by the Royal Canadian College of Osteopathy & Alternative Medicine.

I also consent to participating in all in-class workshops, and I understand that some classes may be recorded for educational purposes. I agree that my work may be used for educational and marketing purposes with my consent.

Student Signature

Date

Payment Method

Credit/Debit Card E-Transfer Check Other

Name on Card

Card Number

Expiration Date

CVV

Billing Address

Please ensure the following documents are attached:

Copy of Photo ID (Passport/Driver’s License) Proof of Education (Diploma/Certificate) English Proficiency Test Results (if applicable) Registration Fee Payment Receipt

Please Upload your Documents

Personal Information

Full Name

Date of Birth

Gender

Address

City

State/Province

Postal Code

Phone Number

Emergency Contact Name

Emergency Contact Phone Number

Relationship to Emergency Contact

Program Information

Program Enrolling In

With Health Background Without Health Background

Start Date

March 2025 September 2025

Preferred Payment Plan

Full Payment Monthly Payment Custom Plan

Educational Background

Do you have a healthcare background?

Yes No

Education History (Up to 3 Diplomas)

Diploma 1

Institution Name

Diploma/Certificate Earned

Year of Graduation

Diploma 2

Institution Name

Diploma/Certificate Earned

Year of Graduation

Diploma 3

Institution Name

Diploma/Certificate Earned

Year of Graduation

English Proficiency

(For non-native English speakers only)

Is English Your First Language?

Yes No (If No, please provide proof of English proficiency)

Consent and Agreement

Student Signature

Date

Payment Information

Payment Method

Credit/Debit Card E-Transfer Check Other

Name on Card

Card Number

Expiration Date

CVV

Billing Address

Supporting Documents

Please ensure the following documents are attached:

Copy of Photo ID (Passport/Driver’s License) Proof of Education (Diploma/Certificate) English Proficiency Test Results (if applicable) Registration Fee Payment Receipt

Please Upload your Documents

Student Registration Form

Royal Canadian College of Osteopathy & Alternative Medicine

You Have two Options to fill the registration form:

Download The Registration Form here

Education History (Up to 3 Diplomas)

Diploma 1

Diploma 2

Diploma 3

English Proficiency

Personal Information

Program Information

Educational Background

Education History (Up to 3 Diplomas)

Diploma 1

Diploma 2

Diploma 3

English Proficiency

Payment Information

Supporting Documents

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Royal canadian college of osteopathy

Contact Information

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