AAPNA Board Certification Application Form

Thank you for your interest in AAPNA Board Certification of Registered Ayurvedic Professionals of Association of Ayurvedic Professionals of North America, Inc. USA. Please complete the form below to submit your details for review and approval. Once you are approved, we will send your digital and snail mail certificates.

Only Registered Ayurvedic Professionals Are Eligible for Board Certification
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Board Certified Registered Ayurvedic Professionals:  {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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1. Reference Person {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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3. Reference Person {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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May AAPNA share your contact information with other ayurvedic resource groups? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Agreement of Understanding Regarding Board Certification: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

{~ 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}
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AAPNA Board Certification Application Form

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

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

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

{binding BillingAddress.FullInternationalAddress}
{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}

Thank you for your interest in AAPNA Board Certification of Registered Ayurvedic Professionals of Association of Ayurvedic Professionals of North America, Inc. USA. Please complete the form below to submit your details for review and approval. Once you are approved, we will send your digital and snail mail certificates.

Only Registered Ayurvedic Professionals Are Eligible for Board Certification
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Website {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Referred by {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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{ binding firstError.message }
Please attach your passport size photo here (.jpeg, .gif or .png) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
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{ binding firstError.message }
Please attach a copy of your AAPNA Registration Certificate {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}

{ binding firstError.message }
Please attach your clinical experience paper (150 - 200 words) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}

{ binding firstError.message }
Board Certified Registered Ayurvedic Professionals:  {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
1. Reference Person {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
2. Reference Person {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
3. Reference Person {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
May AAPNA share your contact information with other ayurvedic resource groups? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Agreement of Understanding Regarding Board Certification: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

AAPNA Board Certification Application Form

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

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

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

{binding BillingAddress.FullInternationalAddress}
{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}

Thank you for your interest in AAPNA Board Certification of Registered Ayurvedic Professionals of Association of Ayurvedic Professionals of North America, Inc. USA. Please complete the form below to submit your details for review and approval. Once you are approved, we will send your digital and snail mail certificates.

Only Registered Ayurvedic Professionals Are Eligible for Board Certification
Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Website {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Referred by {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Please attach your passport size photo here (.jpeg, .gif or .png) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}

{ binding firstError.message }
Please attach a copy of your AAPNA Registration Certificate {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}

{ binding firstError.message }
Please attach your clinical experience paper (150 - 200 words) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}

{ binding firstError.message }
Board Certified Registered Ayurvedic Professionals:  {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
1. Reference Person {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
2. Reference Person {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
3. Reference Person {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
May AAPNA share your contact information with other ayurvedic resource groups? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Agreement of Understanding Regarding Board Certification: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }