Application

Enrollment and payment form for the Introduction to Murray Bowen’s Theory of Human Functioning program. Once you click Submit, you will be redirected to a Paypal page to pay the enrollment fee. If you choose to pay by installment plan, you will need to create a PayPal account if you do not already have one.

Name*
First Last Suffix
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Cell Phone*
Home Phone
Work Phone
Current Position(s)*
Education*
What experience have you had with Bowen theory?*
How did you choose this program?*
What are your goals for engaging in this program?*
Enrollment Fee*
- I would like to pay the full tuition - $600
- I would like to pay in two installments of $300 each
Installment Plan Option
- I would like to pay in two installments of $300 each
The first installment will be $300 USD (due by August 1st). The second installment will be charged $300 USD four months from the payment of the first installment. To pay in installments, you will need to create a PayPal account if you do not already have one.
Total
$0.00