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AINH Application

The document is an enrollment application for the American Institute of Natural Health, Inc. It requests the applicant's contact information, employment details, education history, character references, emergency contact, and experience with colon therapy sessions. The applicant is also asked to write a short essay on the back describing themselves and their plans for becoming a professional colon hydrotherapist.

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Jeremy Nunez
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© Attribution Non-Commercial (BY-NC)
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Download as PDF, TXT or read online on Scribd
73 views

AINH Application

The document is an enrollment application for the American Institute of Natural Health, Inc. It requests the applicant's contact information, employment details, education history, character references, emergency contact, and experience with colon therapy sessions. The applicant is also asked to write a short essay on the back describing themselves and their plans for becoming a professional colon hydrotherapist.

Uploaded by

Jeremy Nunez
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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American Institute of Natural Health, Inc.

Enrollment Application
Applicant Full Name: __________________________________________________
Mailing Address: ______________________________________________________
City: _________________________ State: _________ Zip Code: _____________
Mobile Number: ______________________________________________________
Email Address: _______________________________________________________
Current Employer: ____________________________________________________
Position : ___________________________ Employer Phone: _________________
Education: __________________________ Degree/Licenses Held: ____________
Character References: (Name/Phone/Relationship)
1. _________________________________________________________________
2. _________________________________________________________________

Emergency Contact : (Name/Phone/Relationship)


____________________________________________________________________
Have you ever received a colon therapy session? Yes/No If yes, when, where and what
type of equipment was used: ___________________________________________
___________________________________________________________________

Have you ever administered a colon therapy session? Yes/No If yes, when, where and
what type of equipment was used: ______________________________________
___________________________________________________________________

Using the back of this paper, please tell us about yourself and your current plans
on becoming a Professional Colon Hydro Therapist.
08/2011
21636 N 14th Ave, #A-1 Phoenix, AZ 85027 (t) 1.800.343.4950 (f) 623.581.8724 www.shpinc.net

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