Registration form

Botox/Dermal Filler Advanced Course

Fill out the form below to register for the Botox/Dermal Filler Advanced Course. Once our office reviews your registration form, we will contact you for payment. After your non-refundable payment in full has been received, we will book your training dates.

Name

First

Last

Phone #

Mailing Address

City

Province

Postal Code

How did you hear about us?

Where are you currently employed? You must have minimum two years experience with injecting.

Course Qualification Requirement. I am a:

Registered Nurse

Licensed Practical Nurse

Physician

Dentist

Course Cost

I understand that the cost of this course is $1300.00 + GST. We accept debit, e-transfer, credit card. 50% non-refundable down-payment is due before training dates will be booked.

Please provide proof of your medical licence here.

Maximum file size: 268.44MB

Questions or Comments

Disclaimer: All information is confidential.

If you are human, leave this field blank.

Botox/Dermal Filler Advanced Course Registration Form

Registration form

Botox/Dermal Filler Advanced Course

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