This online registration form allows you to register and pay for your class in one easy step. The down payment for this course is required to complete registration (payment information will be collected at the end of the form).

If you would prefer to mail in a registration form, you can download the Registration Form (PDF).

All fields are required unless otherwise noted.


Course Information:

Semester

Montana and India

Aug 30, 2020 - Nov 13, 2020

$17,000.00

Your Contact Information:

Emergency Contact:

Your Background Information:

Billing Information:

Enter a number only (no dollar sign).
You can pay either an initial down payment (minimum $2,000.00) or the full course cost ($17,000.00).
Enter a number only (no spaces or dashes).
Month
Year
This number can be found on the back of your card.

Billing Address

Please read and review Aerie Backcountry Medicine's School Policies before registering for this course. You will be required to sign this document, in person, on the first day of class. Aerie will provide printed copies in class.

Aerie Backcountry Medicine School Policies

If you have any questions about the requirements or risks involved with this course, please contact us.


Please review all of your information before submitting your registration.
Your credit card will be charged as soon as your registration is successfully submitted.

Note: Aerie will send system-generated emails from info@aeriemed.com. These emails contain valuable and necessary course information. To ensure proper delivery, please check your spam/junk folders and mark info@aeriemed.com as an approved contact.