TREE OF LIFE CENTER
Registered Polarity Program Level-3, 2026
Application & Payment Plan
Name _______________________________ Pronoun____________ Date of Birth _________________
Address____________________________________________________________
Phone’s (cell) __________________________(Other)________________________
Email______________________________________________________________
I would like NCBTMB Continuing Education for my NC LMBT License __________________
_______ I am applying for the 2026 Tree of Life Center's RPP Level -3 program.
Total tuition for the program is $3,175
A $375 program deposit toward the total tuition is due by March 17, 2026.
_____7 Month payment plan of $400 per month OR _____Pay in full by April 17th
Payment options:
-Venmo @JaniceMarie-Durand; Check made out to Janice Marie Durand; Cash.
April _______________$400; May ______________ $400; June ______________ $400;
July _________________$400; Aug. _____________ $400; September ____________ $400; Oct. ____________ $400
NOTES:
Tree of Life Center
Janice Marie Durand
4316 Bradford Ridge Road
Efland, NC 27243