Colonic NetWORK School
100 Hour Course
colonic.net
Become a
Certified
Colon
Hydrotherapist
www.colonic.net
Jeri Tiller, Teaching Business & Ethics, Marketing
We proudly provide LIBBE Device & I-ACT Certification Courses.
Colonic NetWORK School
"Working Together to Educate Health Care Professionals
And Promote Safety to All Colon Hydrotherapists."
Colonic Network Curriculum is based on decades of research and efforts of
Medical and Naturopathic Physicians and Certified Colon Hydrotherapists, which
Provides a unique opportunity to become a Professional Colon Hydrotherapist.
Dr. Bill Tiller, ND. An I-ACT Founding Member and Past President
of both International Association for Colon HydroTherapy (I-ACT)
and the National Board for Colon Hydrotherapy (NBCHT)
Contributed many of the Professional & Educational Standards we honor today.
Colonic NetWORK School Office: 210 308-8888
www.colonic.net Listing of Worldwide Therapists
eMail: info@colonic.net
Fax 210 349-5679
10911 West Ave., San Antonio, TX. 78213
MIND BODY Naturopathic Institute
Texas Licensed Education Provider: Anatomy & Physiology, CEUs & CPR
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Train.11.2013
Colonic NetWORK School
www.colonic.net
I-ACT Certification Level I.
AND LIBBE DEVICE TRAINING ALL IN ONE TRIP!
<< This Class MEETs Required 100 HOUR I-ACT Certification >>
•Nov. 5 - 13, • March 18 - 26, 2014
Comprehensive and Intensive 100 Hour Course
colonic.net
LIBBE Device and I-ACT Certification Investment: $2,000.00
Course Outline;
health & sanitation, business & ethics,
safe advertising, marketing, hands-on internship
theory and history of colon hydrotherapy,
Mind Mapping Techniques which is a fun - easy way
to learn the Digestive System & How it works,
45 hours of Anatomy & Physiology, and
includes cpr certification training, ($60.00 value)
LIBBE Device: room set-up / installation / plumbing
approved supplies & maintenance requirements,
trouble shooting / terminology & mechanics,
safety / contra-indications / side effects,
fda & international laws, legal use & operation.
Training Includes: Pre-Study Guide, Course Material's
2-3 personal colonic's, 2 evenings Soups & 1 Lunch,
Come prepared to do your 15 minute presentation on the digestive
tract demonstrating knowledge & communication to client, You may
use "show & Tell" Items. You will have time to prepare Saturday
afternoon Before Presentation Sunday Morning - make it Fun!
students attending this class that do NOT
have previous a & p course credits to comply with
i-act certification pre-requisite will need to take A&P Test
After they have sat through the A & P taught during Course
Transcript provided with Completion - Test fee is $200.00.
Course Investment Does NOT Include I-ACT Membership Costs
• Membership: $150.00 • Each Test Fee $75.00.
What to Bring: See List Page 7. - Register Page 13 - 15.
VERIFY CLASS SCHEDULES BEFORE AIRLINE BOOKED!
Page 2. Two
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
www.colonic.net
Comprehensive and very Intensive
LIBBE DEVICE TRAINING ONLY
for beginners that want to explore a new profession,
Therapists who want to learn new Technology,
current Legislation and fine tune skills,
by physicians that want to know how to operate
and Maintain or those for personal home use!
50 Hours - Four & 1/2 Days
Investment: $1,000.00
Jan. 21 -25, or Mar. 18 - 22, 2014
Register 30 + days in advance & Save $100.00
Provide Deposit Early for Discount & to hold space!
Class runs Tuesday 8 am. thru Saturday 3:00 pm.
First Two days are very late evenings!
Includes: 2 personal colonic's, 2 evenings Soups & 1 Lunch.
this class teaches and qualifies future
Colon HydroTherapists on how to safely
and legally operate a libbe device!
contra-indications / side effects,
health & sanitation, business & ethics,
safe advertising-marketing, physician interaction
hands-on internship with real clients.
room set-up / installation / plumbing / safety,
approved supplies & maintenance requirements,
trouble shooting / terminology & mechanics,
safe use of disinfecting supplies & disposables.
fda & international laws, legal use & operation.
plan airline departure after 2:00 pm on Saturday
I-ACT WORKS TO ENSURE PROFESSIONAL STANDARDS:
FREE LIBBE Device Review for all previous LIBBE
Trained Therapists - Classes in San Antonio, TX. Only!
Colonic NetWORK School
The International Association for Colon HydroTherapy (I-ACT) advocates the highest standards of
education and professional conduct to assure properly administered colon hydrotherapy.
Today, colon hydrotherapists are thoroughly trained professionals, who must pass rigourous testing
and adhere to strict guidelines established by I-ACT. These professionals are well schooled in the
administering of colon hydrotherapy. Being a member of I-ACT ranks you with the top colon hydrotherapists
nationally and internationally. Plus many States now require I-ACT Certification to practice!
Along with incredible support and networking, membership provides discounts on seminars, annual
Page 3. Three
conventions, regional meetings and access to professional information!
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic NetWORK School
LIBBE Device
www.colonic.net
And First Week I-ACT Level 1 Certification
(Ten Days / 100 Hours required for I-ACT Certification)
Day 1------------------------------TUESDAY - Starts @ 8:00 AM
8:00
9:00
11:45
1:00
1:30
3:00
Greetings, Tour of Center, Introductions, Oath of Commitment, Pick-up Pre-test
EVIEW
R
DIGESTIVE SYSTEM By Dr. Bill
LIST
LUNCH - Nearby / Healthy / Economical / We shuttle you
CHECK .
(Collect Required Prescriptions for Texas) Discuss Client History / Intake Forms PAGE 2
Introduction to LIBBE Device / Terminology / Mechanics / Sanitation
Indications / Contraindications, Intake/History Form History of Colon Hydrotherapy
Basic LIBBE Device Operation - Function / Safety – LIBBE Quick Reference
LIBBE Setup / Training on how to explain sessions of LIBBE Device to Clients
Start Student Individual sessions (Giving and Getting)
ening
Late Ev
Healthy Vegetarian Soup Provided after your session
Day 2----------------------------WEDNESDAY - Starts @ 8:00 AM
8:00
12:00
1:30
3:00
A & P (Digestive System)
LUNCH - Nearby / Healthy / Economical / We shuttle you
Indications / possible side effects / History Colon Hydrotherapy
Importance - Filing - How to start sessions - Setup / Disinfecting LIBBE Device
Student Individual Sessions
Healthy Vegetarian Soup Provided after your sessionate Evening
L
Day 3--------------------------THURSDAY - Starts @ 8:00 AM
Dr. Bill & Students
8:00
12:30
2:00
Business & Ethics - Legal Aspects / Safe Advertising / Marketing
Business & Ethics – Career Paths / Management / Regulations / Physician Interaction
Business & Ethics – Review Legal Safe Supplies & Products / Order Forms By Jeri, Designer
A & P Digestive System
LUNCH - Nearby / Healthy / Economical / We shuttle you
LIBBE Device: Room Set-up / Installation / Function / Troubleshooting / Plumbing /
Safe use of Disinfectants / Maintenance (Monthly & Annually By Tom Technical Manager
Alternative Therapies (Hands - on Reflexology, Lymphatics, Body work)
Prepare for Internship Tomorrow / Review Theory and History of Colon Hydrotherapy
8:00
9:00
10:30
11:30
1:00
A & P Digestive System Review - Take Group Photos
Medical Device Reporting (MDR) By Misty (Attorney/Quality Control)
School Survey / Disease & Infection / Roll Playing / Prepare for Clients
Day 4--------------------------FRIDAY - Starts @ 8:00 AM
LUNCH Provided in Class
ure
Depart
later
r
o
m
p
4:00
INTERNSHIP - Sessions with Clients - 1:00pm. 2:30pm. 4:00pm. 5:15pm.
Review Client Interaction & Evaluations.
Bring Sack Lunch or Snack
Day 5-------------------------- SATURDAY
8:00
12:30
g
ttendin
A
n
e
h
W
Only
s
s
a
l
C
LIBBE Saturday
for Friday Evening & Saturday
PREPARE FOR INTERNSHIP - 9:30am. 10:45am. 12:00pm., (1:15 added when large classes)
Review Evaluations /
Review I-ACT Pre-requisites, and collect
Documents, I-ACT Membership Applications and Fees.
See Item 9. on Page 2. To Prepare for 15 Minute Presentations Tomorrow Morning
Page 4. Four
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic NetWORK School
www.colonic.net
I-ACT Level 1 Certification - Second Week
Certification AGENDA Continued
Day 6 -- I-ACT CLASS Starts @ 10:30 am. Sunday
Bring Sack Lunch or Snack Sunday
10:30 15 Minute Presentations - See Item 9. on Page 2.
12:30 Have Sack Lunch you brought
1:30 CPR Certification (Public and/or Massage Students may join class.)
REVIEW T
LIS
CHECK .
PAGE 2
A&P Students Arrive 8 am and Join I-ACT Students
Day 7-- I-ACT / Day 1. A&P --------Monday - Starts @ 8:00 AM
8:00 Review Digestive System - Begin Anatomy & Physiology
LUNCH - Nearby / We shuttle you
Anatomy & Physiology
Day 8-- I-ACT/ Day 2. A&P ---------Tuesday - Starts @ 8:00 AM
8:00 Anatomy & Physiology
LUNCH - Nearby / We shuttle you
Anatomy & Physiology - (Demonstrate Organ Locations.)
Day 9-- I-ACT / Day 3. A&P -------Wednesday - Starts @ 8:00 AM 8:00 Anatomy & Physiology and Review
LUNCH - Nearby / We shuttle you
1:00 Anatomy & Physiology A&P Tests
A
tudents
S
e
s
r
u
& P Co
:00 AM
8
g.
onday
Start M nesday Evenin
.
ed
Thru W Dates Page 7 e
A & P u may Arriv
Yo
NOTE: ay 10:30 AM
Sund ete I-ACT
pl
To com ns and/or take
0.00
atio
Present ification Fee $6
rt
CPR Ce
3:00 I-ACT Students -- OPPORTUNITY Take I-ACT Test
(1-1/2 Hours time allowed to take Level I. Test)
A & P Students plan departure anytime after 6:00pm. Wednesday.
Shuttled to Hotel to Relax and you will not need to return tomorrow,
Unless you are also eligible to take Level II. Test - So Study Tonight
LAST DAY - IF NEEDED --Thursday
n
tificatioure
r
e
C
T
I-AC ine Depart
rl
Plan Ai day Anytime
Thurs
Bring Luggage if you are going to Airport from School.
8:30 Administer I-ACT Level I. Test for those that did not
take yesterday and Level II. to those eligible.
(Two Hours Time allowed for level II. Test)
Class completed - Students Shuttled to Airport or back to Hotel
Congratulations! Be sure to complete forms that I-ACT office will
be sending you - so that you will get your Certification Certificate.
Transcripts for I-ACT from COLONIC NETWORK School - I-ACT Recognized School
Page 5. Five
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic
NetWORK School
I-ACT
Certification
Levelwww.colonic.net
Requirements
Many States and Countries are changing Laws to Include I-ACT Certification!
I-ACT
Foundation - Level I.
Pre-Requisites:
___ High School/GED or ____ Degree/License
We will need copies of High School/GED,
A & P, Health Care Degrees &/or Licenses.
Foundation LEVEL I.
Business & Ethics
Health & Sanitation
Anatomy & Physiology Theory/History/Practice
Internship "Hands-On"
Presentation - Oral
Complementary
TRANSCRIPT TOTALS
- 5 Hours
- 5 Hours
- 45 Hours
- 10 Hours
- 29.75 Hours
- 0.25 Hours
- 5 Hours
100 HOURS
___ Complete I-ACT Membership Application
The Following completed during Course:
___ Pass A & P Pretest
___ 25 clients documented (hands-on)
___ Receive 1-3 colonic’s (Included)
___ 15 minute Oral Presentation
___ CPR Certification - (Included)
___ I-ACT Full Membership Application
___ Pass I-ACT Level I. Test ($75.00 FEE)
___ Completion of I-ACT 100 hour course @ I-ACT Instructor/School
___ A & P Course (3 Credits) We also Teach - We are a Texas Licensed School
Member Must Send the following items to I-ACT to Complete Level I. Certification!
___ Photos of Facility, (Colonic Room, Waiting Area, Rest room,)
___ 1 copy of health history/Intake/Questionnaire
___ Liability Insurance (Malpractice) Available to I-ACT Certified Members
Be sure to complete the Instructor/School Survey and return to the I-ACT office!!
I-ACT MEMBERSHIP $150.00 LEVEL I. II. III. TEST FEES $75.00 Each
Instructor Level requires additional Fee of $75.00 Annually with Member renewal
Intermediate - Level II Must Complete all of I-ACT - Level I
___ Non-Licensed medical field (no degree) must be Level I. for minimum of 6 months.
___ Pass Level II Test ($75.00 FEE)
___ Two years of practice OR ___ 500 hours of training (Medical Health Care Degrees)
___ 30 minute presentation completed/evaluated
Advanced - Level III Must Have Completed Level I and Level II
___ Non-Licensed medical field (no degree) must be Level II. for minimum of 12 months.
___ Pass Level III Test ($75.00 FEE)
___ Three years of practice OR ___ 1,000 hours of training
CTOR
INSTRU
Instructor Level Must Have Completed all three levels above.
CED &
ADVAN
S ARE
LEVEL
!
EQUAL
___ Demonstrate three hours of teaching abilities @ A I-ACT School
or I-ACT Regional Meeting - Eight people evaluating is desired.
( Presentation Outline and handouts must be sent to School very early for review)
___ Must Complete 60 Hour Instructor Course BEFORE presenting @ I-ACT Convention.
___ Must Attend and Demonstrate / Present One Hour at I-ACT Convention
( Registration, Outline and handouts must be sent to I-ACT office Before Convention )
___ Must prepare a 50 question & answer Test - multiple choice with source documentation
Note: Must be on Digestive System -Education Chairs will evaluate!
INSTRUCTORS MUST attend One Convention every Two Years, Schools attend every year.
Page 6. Six
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic NetWORK School
www.colonic.net
Check List Training Requirements & Preparation:
ALL STUDENTS / ALL CLASSES - Do's and Don'ts
______Register for Class as soon as you can
______After Registration / class is confirmed arrange for travel
______Book Hotel - Early so rooms do not get filled.
______Verify with Hotel -- shuttle Time (7:40am) to Bring you to our Center.
If you do NOT stay at recommended Hotel You must arrange your own transportation to and from center.
Taxis or Rental cars may be expensive. (See Page 15. for Taxi phone # )
•dress comfortable & in Layers. This is TEXAS - We do use Air Conditioning.
•Special Diet needs should be brought with you.
•Please respect others and our clients - do not wear perfumes.
•Please Silence Cell phones during class - Breaks are provided.
•You are NOT allowed to promote or sell anything - students are here to
Learn about Colon Hydrotherapy and will be overwhelmed as it is!
•Agendas are flexible based on knowledge base of all students in class.
•Please always Arrive each morning Before Class Time, and arrive Healthy
(no colds, coughs, Etc:) with a positive outlook for a fun learning experience.
Notice: Pre-Study Guide included with Registration is sent with a LIBBE Catalog, Current LIBBE price's and the complete Plumbing Instructions.
Other Training Guides / Materials are provided to students during training.
LIBBE and I-ACT Certification
I-ACT Certification is Long 100 Hours - In-Class Required!
May Travel One Trip or Two (Two Trips will require Two Airline Tickets)
Arrive no later than sometime Monday Before class Starts Tuesday 8am.
(International Students should arrive couple days early to rest before class starts)
Preparation: Bring ALL Above - Plus the following for San Antonio;
1.______ personal Prescription: (PAGE 9.) you will be getting and giving Colonic’s
2.______ Bring The Pre-Study Guide we shipped to you.
3.______ Bring Your completed Pre-Test. (Pre-Test determines Knowledge Base of Students)
4.______ During Internship you should Bring and wear Scrubs.
5._____ I-ACT Membership Fee $150.00 and Test Fee $75.00
6.______ Copy of High School Diploma / GED and/OR
7.______ Copies of any Health Care related Degrees or License AND/OR
8.______ Copies of Transcripts with any A & P Hours completed.
9.______ Come prepared to do your 15 minute presentation on the digestive
tract demonstrating knowledge & communication to client, You may
use "show & Tell" Items. Presentation Sunday Morning - make it Fun!
10.______ Ladies will be kneeling on floor CPR Certification - bring & wear pants
11.______ Plan to Bring Sack Lunch's for classes on Saturday & Sunday
12.______ Be sure to Bring an enthusiastic desire to learn and have fun!
Page 7. Seven
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Reach higher levels of Certification through Education!
Colonic NetWORK School
www.colonic.net
Travel / Train for All Hours or when needed
You may Split Training into Multiple Trips.
Post Secondary (A&P)
Anatomy & Physiology Course
3 Days • 30 Hours CEUs • Monday thru Wednesday
November 11-13, or March 24-26, 2014 $200.00
Includes: Materials, A & P Test & Transcript
Meets I-ACT A & P Pre-Requisite or Earn NBCHT CEUs
ADVANCED A & P Course
Review for I-ACT Level II., or III. Tests
FEE: $250.00 Plus Earn NBCHT CEUs
3 Days - 30 Hours Nov. 15-17, Mar. 28-30, 2014
Fri. - Sat. - Sun. - 8 to 6 pm •Test Sunday after lunch
Must be at Minimum I-ACT Level I. - Test Fee: $75.00
* Register Right Away - To Hold Place! *
Arrive Thursday - Plan Departure Sunday After 5:00 pm.
Instructor Training - March 3 - 8, 2014
7 Days / 60 Hours • Investment $1,250.00
Monday thru Saturday - 8 to 6 (Arrive Sunday - Depart Sun. Anytime)
• Designed to Complete I-ACT Instructor Requirements
• Complete your 3 hours of presentation Using Power point
• How to conduct a class - Prepare training materials.
Come prepared to present A & P - Digestive System.
(Must be Certified at Level III. to attend this Course.)
Learn from the Best! Register early - Limited 10 Students!
Course Dates Pending
Page 8. Eight
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
www.colonic.net
STUDENTS Please BRING WITH YOU TO TRAINING
Colonic NetWORK School
Personal Prescription Requirement
Training includes YOU Getting Colonic Sessions.
This is part of the "Hands-On" Training.
In Texas to Receive Colonics - A Prescription (Rx) is Required.
Please Contact your Personal Physician. (Rx) may be on
Dr's. Script Pad or your Dr. may use Sample below.
Bring with you OR RX May Be Faxed to School at 210 349-5679
Should You arrive without your Rx We have a Physician in our Building - His Fee will be $50.00
Please try to bring with you, as to visit with Dr. Belalcazar,
depending on his schedule will slow down the entire class.
OR Please schedule flight to arrive early Monday and have shuttle
bring you to Center and see Doctor on Monday afternoon before 4:00
LE Physicians Name___________________________________
P
M
SA
Address___________________________________________
City_______________________________________________
State_____________________ Zip_____________________
Office Phone ________ ___________________
Patient Name: ___________________________________________
Address___________________________________________________
This Rx is for "Colonics as Needed"
X ___________________________________
Type:__________
Date___/___/____
Lic#: ___________________ State: ______
“U.S. Food & Drug Administration (FDA) Code of Regulations”
FDA (Class II.) Colon Irrigation Systems, are prescription medical devices
and are approved only for colon cleansing,
when medically indicated, such as before radiologic or endoscopic examinations.
This is NOT Prescription to Purchase LIBBE and Supplies
Page 9. Nine
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic NetWORK School
www.colonic.net
COLON HYDROTHERAPY MEDICAL DEVICE REGULATIONS:
US - FDA (Food & Drug Administration): Requires Colon Hydrotherapy Device
Manufacturers to provide a source for users (Therapists) to complete Training.
A sampling of Training would be; Hands-On Safe Operation, Contraindications,
Medical Device Reporting (MDR), Manufacturer Guidelines on Maintenance
Requirements to prevent Bacteria Growth, and to only use Products that the
Device Manufacturer was required to complete strict and rigourous Testing
on - before FDA and International Medical Device Licenses were approved.
Testing included; Toxicology, Biocompatibility, Safety, Electrical and others!
Additionally, each Medical Device purchaser must obtain a Prescription
from a Licensed Health Care Practitioner to purchase the Colon Hydrotherapy
Medical Device and the pre-tested and properly labeled Rectal Tubes or Nozzles.
International: Medical Device Agencies and License requirements are the same.
California: Alternative Health Care Senate Bill SB 577,
(You may download this California Bill by checking on Google.)
Colorado and Connecticut: requires every person performing
Colon Hydrotherapy be I-ACT Certified or NBCHT Credentialed.
(Training includes how-to-operate & maintain the FDA Device.)
Illinois: requests all Therapists comply with I-ACT Advertising Standards.
Iowa: State laws do not allow Colon Hydrotherapy or Enemas by anyone!?
Florida: requires must first be a Licensed Massage Therapist, then complete
a 100 hour course in Colon Hydrotherapy and pass testing with
NBCHT (National Board for Colon HydroTherapy).
(Training includes how-to-operate & maintain the FDA Device.)
Texas: The Attorney General “Therapists must be trained and purchase FDA
Colon Irrigation Devices with a prescription from a Licensed Health Care
Practitioner from The State or Country sessions are being provided.
Plus Centers in Texas must obtain a prescription for client before the session."
Washington: requires all Therapists be trained and have oversight
from a Licensed Naturopathic Physician (ND).
Complaints and Health Inspections: because of Un-trained persons and/or those
using Un-approved Products have developed over the years in these States;
Louisiana, Georgia, Hawaii, Michigan, North Carolina, Wisconsin, and others.
States may possibly begin legislation or other actions that would require
ALL Therapists to become I-ACT Certified. That would be a Blessing!
BEST To Become Certified and then you are ahead of any legal changes!
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
www.colonic.net
Upscale - Very Popular!
Colonic NetWORK School
aloft Hotel
838 NW Loop 410, San Antonio, TX 78216
www.aloftsanantonioairport.com
210 541-8881 Ext. 0 Credit Cards Only! No Cash or Checks
Ask For MIND BODY Special Rate $84.00 (Regular Rate: $159. to $209.)
Single / Double or King Loft - Rate Based on Availability - MUST RESERVE EARLY!
Complimentary Internet, 42” Plasma TV, Heated Pool, Fitness Center, Lounge, 24/7 Food Service,
You are in Class Many Hours - so no need for a room with a Kitchen - Plus Nearby are Eleven Assorted
Restaurants, Target, Sears, Theatre, Comedy Club, Nail Salon, all walking distance and so much more!
aloft SAVEs on Transportation! No Need to Rent a car or pay for a Taxi
FREE Shuttle to/from Airport and To SCHOOL each Morning!
Be Ready in Lobby by 7:30 am. each Morning for Shuttle - (Class Starts 8:00 am)
Manager Email: Johnny.Martinez@aloftsanantonioairport.com
NW Mil
l Se
itary Hw
N.W. LOOP 410
y.
Rd.
aloft HOTELS
838 nw loop 410
@ Blanco Rd.
ro A
ve
*
lma
Ped
khil
N
San
Loc
W
es
Colonic School
10911 West Ave.
tA
ve
Blanc
o
LIBBE Colonic Center
*
North Star Mall
Great Shopping
N.E. LOOP 410
Located and easily found in
Beautiful South Central Texas,
(North Central San Antonio)
Airport (6 mi.), Aloft (4 mi.)
Home of the Alamo (16 mi),
Sea World Fun Park (25 mi),
Six Flags-Fiesta Texas (20 mi),
San Antonio Spurs (16 mi),
and you stay over and visit the
extremely fun & popular
Downtown RiverWalk (16 mi).
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic NetWORK School
www.colonic.net
VERIFY CLASS BEFORE AIRLINE BOOKED!
This page can be for Airline and Travel Notes:
DEPART: Confirmation # ______________________
Date _______________________
Time:___________________
Airline_____________________
Flight # _____________________
RETURN HOME: Confirmation # ______________________
Date _______________________
Time:___________________
Airline_____________________
Flight # _____________________
aloft Hotel
Manager Email: Johnny.Martinez@aloftsanantonioairport.com
Name of Hotel Staff:_____________________
Dates: _____/______
to
_______/________
Confirmation #_____________________________
838 N.W. Loop 410
San Antonio, TX 78216
210 541-8881 Ext. 0
IF you do not use Hotel we recommend.....
These are some Area Taxi Services:
Yellow Phone: 210 222-2222 www.yellowcabsa.com
SA Taxi Phone: 210 444-2222
Best to pre-arrange schedule for pick-up / delivery to class, so that
you arrive by/before 8:00 am each morning. please do not be late.
classes can go rather late evenings, a schedule of when to pick you
up can not be provided. sometimes you may have to wait out front of
school until your Taxi arrives.
COLONIC & MIND BODY CENTER 10911 West Avenue
San Antonio, TX 78213
Center phone: 210 342-7444
School Phone: 210 308-8888
Page 12. Twelve pages
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic NetWORK School
www.colonic.net
ASE
PLE T! TRAINING REGISTRATION colonic netWORK School
N
PRI10911 West Avenue, San Antonio, texas 78213 210 308-8888
NAME_____________________________________________
Home/Cell PHONE
________________
ADDRESS________________________________________________________ APT / SUITE #_________
Do N0T use P.O. # - MUST have a Street Address for UPS Delivery!
CITY____________________________________________ STATE ___________
Province______________ Country___________
Birth Date __________
ZIP _______________
NickName ______________
Business Phone: _____________________________ Fax________________________________________
International Please provide Phone and Fax Number with Country code - 011 +
Your personal E-mail:________________________________________ Occupation: ___________________
COPIES OF FOLLOWING REQUIRED TO COMPLETE I-ACT CERTIFICATION COURSE:
• High School _____ or GED ____ School Transcripts: _____________________ Year_______ • Anatomy & Physiology: Where? ___________________ Date: ___/ ____ / _______ NO _____
• CPR Certification: Where? ________________________ Expires: Date: ___/ ____ / _____ NO _____
COPIES OF FOLLOWING RELATED To HEALTH CARE (IF You have them) -- NOT REQUIRED
• DEGREE:____________________________________ Expires: Date: ___/ ____ / _______ NO _____
• LICENSE:____________________________________ Expires: Date: ___/ ____ / _______ NO _____
• OTHER: _____________________________________ Expires: Date: ___/ ____ / _______ NO _____
What do you expect to do with the experience you get from this training? ____________________________
_______________________________________________________________________________________
How did you find us or who referred you to our school? _________________________________________
Please Print NAME to appear on "CERTIFICATE of TRAINING"
_____________________________________________________________________
INITIALS AFTER NAME ONLY USED WHEN DEGREE PROVIDED
MAKE CHECKS PAYABLE TO:
Colonic NETWORK School
10911 West Avenue,
San Antonio, TX. 78213
210 308-8888 office
210 349-5679 fax
info@colonic.net
Your Emergency Contact:
Name:_____________________
Phone _____________________
Relationship_________________
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic NetWORK School
www.colonic.net
Back page of Application
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
www.colonic.net
Colonic NetWORK School
COLONIC NETWORK SCHOOL REGISTRATION FORM --- PAGE TWO OF TWO
REGISTER USING PAY PAL ACCOUNT OR FAX BELOW Authorization FOR PAYMENT
$800.00 DEPOSIT REQUIRED FOR LIBBE Class, I-ACT Course or INSTRUCTOR COURSE.
COURSE BALANCE PAYABLE UPON ARRIVAL TO CLASS.
FULL AMOUNT REQUIRED WITH REGISTRATION FORM FOR ALL OTHER COURSES.
EARLY REGISTRATION OR MULTIPLE STUDENT DISCOUNTS APPLIED UPON ARRIVAL.
REGISTER EARLY & SAVE
CLASS DATE
LIBBE 4-1/2 Day ONLY
I-ACT - Certification 5 Day
COURSE
____/____/20___
$1,000.00
$800.00
_____
____/____/20___ $1,000.00
$800.00
_____
$
200.00
$200.00
_____
(Translator Fee - You Must Bring your own Translator)
Basic A&P Course
DEPOSIT
____/____/20___
$ 200.00
$200.00
_____
Advanced A&P Course
____/____/20___
$ 250.00
$250.00
_____
Instructor Course 60 Hours
Mar. 3, - 8, 2014
$1,250.00
$800.00
_____
CPR Certification - 4 Hours
____/____/20___ $
$ 60.00
_____
Adult Learners Course
PENDING
$ 500.00 $500.00
_____
$
$ 100.00
_____
Late Registration Fee:
60.00
100.00
Fax: 210 349-5679 or
Email: info@colonic.net
THESE CARDS ACCEPTED By FAX: Master CARD____ VISA _____
CREDIT CARD # _______________________________________
Expiration ____ / ____
Security code (_______)
Zip_________
Printed Name on Card:________________________________
Address: _________________________________________
_________________________________________________
Phone # of Card Holder
____ _____ ________
Signature Authorizes Payment of $_____________
X ______________________________________________
ALWAYS Verify YOU Are Registered Before your Airline is Booked
Late Registration of $100.00 when Registration not received 5 days prior to Course Date.
Refund Policy: Written notice sent a minimum of Five (5) days before Course Date(s).
$300.00 Non-Refundable OR Student must attend next scheduled Class.
NOTICE: We do not provide job placement or Employment guarantees as part of training.
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic NetWORK School
www.colonic.net
Financing / Leasing Benefits:
BANKS:
Provide Great Financing Opportunities but require strong collateral.
Recommend you contact the bank you have a relationship with!
LEASING COMPANIES:
• Business leasing does not go on personal credit history
• Provides added business credit availability and cash flow
• Payments fully tax deductible on business tax returns.
Attached Lease Application:
Paramount Financial with representative Craig Colling, who has
been working with many LIBBE Owners to reduce capital outlay.
Estimated Costs to purchase a LIBBE USA Mainland:
Choice of OAK OR MAPLE Stained WOOD CABINET
LIBBE WOOD (Oak or Maple) Cabinet
INITIAL SUPPLIES
SHIPPING/Handling (Estimated)
Sub Total * Discount: LIBBE Training
* Discount (up to) Initial Supplies
* Discount (up to $500.00) off Shipping
Estimated: $ 10,448.00
$ 852.00
$ 700.00 $ 12,000.00
-($ 1,000.00)
-($ 500.00)
-($ 500.00)
$ 10,000.00
* DI SCOUNTS FOR SUPPLIES & SHIPPING EXPIRE 11/22/13
NOTE: Leasing Company will NOT Finance the Training or Travel expenses!
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic NetWORK School
www.colonic.net
LIBBE DEVICE LEASE APPLICATION
COMPANY NAME:__________________________________________________________________________
COMPANY ADDRESS: CITY / STATE ZIP CODE COUNTY
__________________________________________________________________________________________
BUSINESS TELEPHONE: BUSINESS FAX: E-MAIL: FED TAX ID#
__________________________________________________________________________________________
TYPE OF BUSINESS: CORPORATION [ ] PARTNERSHIP [ ] SOLE-PROP [ ] NON-PROFIT [ ]
YEARS IN BUSINESS: ________
NATURE OF BUSINESS: ________________________________
PERSONAL INFORMATION ON OFFICERS, PARTNERS, OR GUARANTORS:
NAME: TITLE
SOCIAL SECURITY NUMBER % OWNERSHIP
_________________________________________________________________________________________
HOME ADDRESS: CITY, STATE ZIP CODE
_________________________________________________________________________________________
HOME PHONE: DO YOU OWN OR RENT YOUR CURRENT RESIDENCE?
_______________________________
[ ] OWN [ ] RENT
NAME: TITLE SOCIAL SECURITY NUMBER % OWNERSHIP
_________________________________________________________________________________________
HOME ADDRESS: CITY, STATE ZIP CODE
_________________________________________________________________________________________
HOME PHONE: DO YOU OWN OR RENT YOUR CURRENT RESIDENCE?
_______________________________
[ ] OWN [ ] RENT
COMPANY BANK STATEMENTS
Proving bank statements is not always a requirement of the credit application process but can have a significant
impact on the approval process and payment.
If requested, would you be willing to supply bank statements? [ ] YES [ ] NO
PLEASE EMAIL OR FAX YOUR LAST 3 MONTHS BANK STATEMENTS (include copy of Application) TO:
credit@paramountfinancial.com or Fax: 480-222-0312
DECLARATION / AUTHORIZATION
The undersign agrees that the information provided above, together with any financial statements, schedules, or
other materials provided to Paramount Financial Services, LLC, "PFS" is true, correct, and complete.
The undersigned authorizes PFS to obtain the credit history of the undersigned and the officers and principals of
the company and to investigate (directly or indirectly) such credit history from any source for the purpose of
entering into an agreement or for servicing such agreement.
APPLICANT:_______________________SIGNATURE:_________________________TITLE:_______ ____/____/____
APPLICANT:_______________________SIGNATURE:_________________________TITLE:_______ ____/____/____
EQUIPMENT DESCRIPTION
AMOUNT FINANCED
LIBBE Colonic Irrigation Devices and Supplies
$__________________
FAX COMPLETED APPLICATION TO: 480-222-0312
** www.paramountfinancial.com Phone 877-948-6200 Ex 101
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679
Colonic NetWORK School
www.colonic.net
10911 West Avenue • San Antonio, Texas 78213 • 210 308-8888 • Fax: 210 349-5679