AAPNA Corporate / School Membership Application / Renewal

Ayurvedic schools and businesses interested in joining AAPNA, please fill out the membership application below. Please be sure to fill in all the * required fields. Once you fill and submit the form, continue to your payment.

Corporation / School Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Primary Contact {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Website {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Day Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Mobile Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Referred by {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Please attach your logo here (.jpeg, .gif or .png) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Please attach a copy of your documents of incorporation. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

SELECT THE APPROPRIATE MEMBERSHIP

Members who register for 10 years are AAPNA Ambassadors and will receive an additional certificate indicating so.

Membership Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Membership Term {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{{ ['2 Years - $400.00','5 Years - $800.00','10 Years - $1,200.00'][$index] }}

Professional Ayurvedic Continuing Education (P.A.C.E.) Provider {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{{ ['2 Years - $200.00','5 Years - $400.00','10 Years - $700.00'][$index] }}

Agreement of Understanding Regarding P.A.C.E. Providers' Code of Conduct and Agreement

As an applicant for approval, I/our organization agree(s) to:

1. Provide accurate information to AAPNA in all transactions to the best of our knowledge.
2. Assure that course credits are awarded only to individuals who successfully complete the course according to the published requirements.
3. Conduct our operations and programs in an ethical manner that respects the rights and worth of the clients we serve.
4. Use and display the provider statement and logo according to AAPNA requirements.
5. Furnish requested information and work cooperatively with AAPNA.
6. Accept that AAPNA audits courses for purposes of compliance with its criteria.
7. After due review and comment period, abide by any revisions of the criteria or inform AAPNA of any intention to withdraw as an P.A.C.E. Provider.
8. Maintain compliance with AAPNA’s Code of Ethics, Standards of Practice, policies and procedures.
9. Adhere to AAPNA's criteria/standards or relinquish the AAPNA approval status after due process.
10. Report any major organizational or program change that impacts the operation of the administrative unit on which provider approval is based to AAPNA within thirty (30) days.

I agree to and understand all the points in the P.A.C.E Providers' Code of Conduct and Agreement Above {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

May AAPNA share your contact information with other ayurvedic resource groups? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Agreement of Understanding Regarding Membership {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

{~ Payment_Block_Label}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{binding Name}:	{binding displayValue}	---

{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}

AAPNA Corporate / School Membership Application / Renewal

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}

{{ Cognito.resources['order-date-label'] }}: {binding displayValue}

{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{binding BillingName}

{binding BillingAddress.FullInternationalAddress}

{binding PhoneNumber}

{binding EmailAddress}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:	({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:	{binding displayValue}

Corporation / School Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Primary Contact {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Website {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Day Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Mobile Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Referred by {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please attach your logo here (.jpeg, .gif or .png) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Please attach a copy of your documents of incorporation. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

SELECT THE APPROPRIATE MEMBERSHIP

Members who register for 10 years are AAPNA Ambassadors and will receive an additional certificate indicating so.

Membership Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Membership Term {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Professional Ayurvedic Continuing Education (P.A.C.E.) Provider {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Agreement of Understanding Regarding P.A.C.E. Providers' Code of Conduct and Agreement

As an applicant for approval, I/our organization agree(s) to:

I agree to and understand all the points in the P.A.C.E Providers' Code of Conduct and Agreement Above {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

May AAPNA share your contact information with other ayurvedic resource groups? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Agreement of Understanding Regarding Membership {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

AAPNA Corporate / School Membership Application / Renewal

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}

{{ Cognito.resources['order-date-label'] }}: {binding displayValue}

{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{binding BillingName}

{binding BillingAddress.FullInternationalAddress}

{binding PhoneNumber}

{binding EmailAddress}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:	({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:	{binding displayValue}

Corporation / School Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Primary Contact {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Website {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Day Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Mobile Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Referred by {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Please attach your logo here (.jpeg, .gif or .png) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Please attach a copy of your documents of incorporation. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

SELECT THE APPROPRIATE MEMBERSHIP

Members who register for 10 years are AAPNA Ambassadors and will receive an additional certificate indicating so.

Membership Type {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Membership Term {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Professional Ayurvedic Continuing Education (P.A.C.E.) Provider {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Agreement of Understanding Regarding P.A.C.E. Providers' Code of Conduct and Agreement

As an applicant for approval, I/our organization agree(s) to:

I agree to and understand all the points in the P.A.C.E Providers' Code of Conduct and Agreement Above {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

May AAPNA share your contact information with other ayurvedic resource groups? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Agreement of Understanding Regarding Membership {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

AAPNA Corporate / School Membership Application / Renewal

{~ Payment_Block_Label}

AAPNA Corporate / School Membership Application / Renewal

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-billing-info-header'] }}

AAPNA Corporate / School Membership Application / Renewal

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-billing-info-header'] }}