You will be responsible for:

Please fill out this form and click the "Send" button. Fields marked with * are required

1. Your Name* 2. Email Address* 3. Country of Origin 4. What languages do you speak? 5. Age 6. Female/Male 7. When are you planning to come? 8. How long do you plan to stay? 9. Contact telephone or cell phone number 9a. Best time to call? 10. Do you have a SKYPE address? What is it? 11. I would like to go to Any Clinic     Toru Clinics     12. What qualifications (or training, experience) do you have in homeopathy, naturopathy, acupuncture, health care or medicine? (please, no long CV or history is necessary, just keep it simple) 13. If you are still a student in alternative medicine, do you have any experience in prescribing? Can you hold your own in case-taking and prescribing? How long have you been studying? 14. If you have no training in alternative medicine or any medical field, suggest to us how you think you can be an asset in this program? 15. Why do you want to come to Africa? Why did you choose this program? What are your personal goals for coming? 16. Practitioners only: describe what type of prescribing you are practicing. 17. Practitioners only: would you be prepared to participate in the mobile clinics which depend on therapeutic or acute-style prescribing? 18. Have you worked with HIV/AIDS patients in your practice? Do you feel capable to work with such patients? 19. Are you interested in teaching? (any subject- Homeopathy, Naturopathy, Human sciences) Anything in particular? 20. Please write anything else you can think of that will help us get to know you better. 21. How did you find out about us?