Use this form to enroll by Toll Free fax...

1. Fill out the form   2. Print the form   3. Fax the form Toll Free to 1 866 209-5111

STEP 1 - Please enter your personal information...

Your Name - EXACTLY as you want it on your certificate: 
Your Name - As you want it on your name badge:
  Company name:
  Referred by :
 

Mailing address

  Street :
  City:
  Province:  
  Postal code:  
  Business Phone:     Ext:
  Fax:   
  Home Phone: 
  E-mail Address: 
  Degree/s Held:
  License/s:
  Designations or certifications
  * Have you ever been convicted of a Criminal Offence for which you have not been granted a pardon? NO    YES
 
 

* Have you ever been disciplined or had any restrictions placed on any professional licence that you hold by any Regulatory Body or Association?   NO    YES
 
  * A positive answer to the above does not mean that you may not apply but be prepared for a delay in your enrollment while we investigate your circumstances.

STEP 2 - Tuition Fees...

The classroom program tuition fee is currently $995.00 + Applicable tax
The distance learning program tuition fee * $1,095 + Applicable tax
The Enhanced Distance Learning program tuition fee $1,195.00 + Applicable tax

All study methods include a comprehensive study guide and your first-year EPC membership is waived.
Participants must complete and pass a written examination at an authorized testing centre before being awarded the Elder Planning Counselor (EPC) designation.

STEP 3 - Please select the Study Option/Location closest to you:

 

STEP 4 - Please select a Payment Plan for your program:  

Please note -
A $25.00 Administration Fee is added to the fee for all Students that wish to take advantage of our Installment Payment  Option.

Option 1 - Full Payment

Live Class: 
$995.00 + Applicable tax

Distance Learning Course: 
$1,095 + Applicable tax

Option 2 - Installment Plan - Only available for live class

Live Class: 
$995.00 + $25.00 Administration Fee Applicable tax X 4 equal payments

STEP 5 - Please select your desired method of payment:

For Credit Card Payment/s - We accept the following cards

Card Number:  ---    Expiry Date     

Name on card:

For Payment/s made by Cheque
Make cheques payable to - CIEPS

I will ICS my cheque/s    I will Mail my Cheque/s

Mail or ICS cheques to

Canadian Initiative for Elder Planning Studies
4438 Ontario Street Suite 203
Beamsville, ON
L0R 1B5

Note - Your designation will be granted when you have successfully passed the exam and your tuition is paid in full.

$100.00 Corporate tuition discount from the current posted tuition fee is available for groups of ten or more from the same company attending the same class. 

The annual $150.00 Elder Planning Counselor membership fee for the first year is waived upon payment of  the tuition fee. 
 

Cancellation Policy: 
Amount of tuition paid, less a $50 cancellation fee, will be refunded if the materials are returned unused within 30 days of receiving same.

CLICK HERE TO RETURN WHEN FINISHED PRINTING

This web site Copyright © 2013 Canadian Initiative for Elder Planning Studies Inc.