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Addiction Recovery Life Coaching Form

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1. Fill out application
2. Make a payment below

Application Form 

 

Do you have history or record of criminal/sexual offence or any proceedings initiated?
Which program are you applying for?

Your application has been received.

To finish application, please make a payment below.

Finish your registration by making a payment below:

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Payment Plan: 4 monthly payments of $375

One time payment of $1500

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