* Start Earning Board Certification Today!  Board Certified Master or Board Certified Doctor of Positive Psychology, Neuropsychology, or Positive Neuropsychology!

* Start a Counseling, Consulting, Teaching, or Training Practice! Take Your Current Practice to the Next Level!

NO STATE LICENSING REQUIRED!

Understanding the Science of Human Nature and Flourishing!

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Enrollment Form

1.  Please copy and paste this form into an email!

2.  Fill in the information requested below!

3. Email to [email protected]

Thanks!


Full Name:

Mailing Address:

City, State, and Zip:

Email:

Web (if any):

Phone:

Practice or Business Name (if applicable):

Occupation:

Degrees, Certificates, Designations, Diplomas, Seminars, Programs Completed:


Have you read any books or completed any courses or programs in positive psychology? If so, please list:


Why are you interested in enrolling in one of our programs?


What is it about positive psychology that interests you?


Please Check Your Choice of Programs

  • Board Certified Master of Positive Psychology  _____, or Positive Neuropsychology  _____, or Neuropsychology  _____.
  • Tuition is $5,998 - $3,000 = $2,998 or $298 per month for 12 months

  • Board Certified Doctor of Positive Psychology  _____, or Positive Neuropsychology  _____, or Neurosychology  _____.
  • Tuition is $6,998 - $3,000 = $3,998 or $377 per month for 12 months.

_________________________________________

Payment Information

Name on Card:

Address on Card:

City, State, and Zip for Card:

Card Number:

Expiration Date:

Security Code:

________________________________________

I authorize payment of the Enrollment Fee of $98, which is in addition to tuition.

MASTER:  I authorize single pay tuition of $2,998 _____ or $ 298 per month for 12 months _____

OR

DOCTOR:  I authorize single pay tuition of $3,998  _____ or $377 per month for 12 months  ____

By signing below with my electronic signature, I agree to complete all monthly tuition payments, if any,

even if I change my mind later.  Once you have received program materials, there are no cancellations!  

 

___________________________________________________

Type your name as your electronic signature

Date:  

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