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                Canada's Wholistic (Holistic) & Alternative Directory
 
 
 
 
 
                                  
 
 
 
REGISTRATION FORM
for
CANADA'S WHOLISTIC & ALTERNATIVE DIRECTORY
or email: bucklers@shaw.ca for form and more information
 
by: COCHRANE & AREA WHOLISTIC COMMUNITY
                
Name:                  _____________________________ 
Phone:                  _____________________________
Located at/clinic: _______________________________________________________
Address:              _____________________________________________________________
 
Mailing Address:_______________________________________________________
 
Web Page Site:________________________________________
Email Address:_____________________________
Date of Registration:_________________________
Paid by cheque #:  __________________________
 
Specialties for listing:
1. 
2. 
3. 
4.
5. 
 
We require that you submit a bio or write up for your listings, in Word.
 
                WEB PAGE LISTING  
 
- Listing under two sections: directory by city / town  and in the directory by practitioner specialty listings
- You have up to 5 specialty listings to register under for the modalities that you have to offer
- Listing in the featured members on the site and in the newsletter each month - rotation of members
- Rotating business cards in newsletter and web site on a monthly basis
- Additional advertising postings
 
This service is $55.00 a year, and covering Canada.   Payable in Canadian Funds
 
Please email your personal Bio in Word to:  bucklers@shaw.ca
 
Please print and fill out the registration form and submit with a check to:
 
Cochrane & Area Wholistic Community
   221 Baird Ave.   
Cochrane, AB    T4C 1C8  
 
Thank you