EO Bundle Registration

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2710 Del Prado Blvd. South, Unit 2-314 Cape Coral, FL 33904

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EO Bundle Registration

Registrant Information - Step 1 of 4

Name *

First

Last

Email Address *

Email

Confirm Email

Cell Phone *

Date of Birth *//

Please Specify Discipline (Optional)

RN/ARNP/LPN/CNS
RT
CNA
NH/AIT
DN/DH
LMT
OT/COTA
RD/ND/NC
MW
LCSW/LMFT/LMHC
AP
Fitness Professional (NASM/AFFA)
Other
Not Applicable

*Only required if you are one of the professions listed above and you wish to obtain CE Credits.

Professional License Number (Optional)

*Only required if you wish to obtain CE Credits. Please make sure your professional license information is accurately entered in order to receive your CE Credits in a timely manner.

Name as it appears on card *

First

Last

Credit Card Type *

Card Number *

CSV *

Please provide the CSV code typically located on the back of your card.

Exp. Date *

Address - Associated with Credit Card *

Address Line 1

Address Line 2

City

State

Zip Code

Is your shipping address the same as above? *

Please Provide Your Preferred Shipping Address *

Address Line 1

Address Line 2

City

State

Zip Code

How did you hear about our courses? *

Do you currently use essential oils? *

If you answered "Yes" above, What brand? *

Are you a current wholesale customer or wellness advocate? *

Waiver 2 *

I understand that any unauthorized reproduction, recording, photography, screen sharing, or replication of material provided in this course, including but not limited to all visual, verbal and written, information for any purpose is strictly prohibited.

Waiver 1 *

I understand that the course itself is NOT commercialized or associated with any one specific essential oil brand. I am receiving access to the ISFTA Essential Oils Certification Course Bundle at a discounted rate which includes a dōTERRA wholesale account. I understand that my wholesale account is good for one year from the date of purchase and will not renew without my authorized consent.

Name