The Holistic Cannabis Nurse Program Application
Please leave this field empty.
Mailing Address
Emergency Contact
Please provide an emergency contact in the event that we are unable to contact you during the program.
Admission Questions
How did you hear about the program?The CIINDE The Cannabis Nurse Friend Referral Other
[group group-friend]
Yes No
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Please select an option below that best represents why you want to take the Holistic Cannabis Nurse Program:I use cannabis personally and want to know more Many clients are using cannabis and I want more information I want to start an independent practice Other
Education & Experience
Please upload a copy of your current registration (2MB max file size)
Please attach a current copy of your CV/Resume (2MB max file size)
Note: If you are unable to upload documents, please forward via email attachment to info@theciinde.com .
Nursing role:Registered Nurse Nurse Practitioner Registered Practical Nurse/Licensed Practical Nurse Registered Psychiatric Nurse
Payment Options:
Pay in Full Make two equal payments with a 3% financing fee
Eligibility
I have read and understand the Eligibility Requirements (link opens in a new window).
Yes No
I have read and understand the Tuition Payment & Refund Policy (link opens in a new window).
Yes No
I have read and understand the Course Agreements (link opens in a new window).
Yes No
I have read and understand the Terms & Conditions (link opens in a new window).
Yes No
Permission Statement
We like to capture special moments! These may be in the form of photographs, testimonials or poignant statements or testimonials shared by students in writing or in open discussion. Having said this, we would not share something personal in nature or that would be considered confidential (e.g. a personal story or struggle shared by a student).
An example of a statement we would share is "developing a deeper sense of self-awareness was the missing piece in truly caring for myself", or "I have seen the magic that can happen when nurses use a holistic approach in the palliative care setting". The intention is to celebrate and showcase the important work you are all doing and the importance of holistic nursing and nurse coaching for both the nurse and their clients. Places we post are on our social mediaplatforms and in our newsletters, quarterly journals, website, etc. To give credit where credit it due, we like to add your name or initials.
I agree to the use of my photo, testimonial and full name I agree to the use of my photo, testimonial and initials I disagree
Acknowledgement
By signing your name below, and clicking YES, you acknowledge that you have fully read this agreement and agree with the terms and conditions presented.
Yes No
On submission, a copy of this application will be sent to your email. You will then be redirected to the payment page.
