Equine-Facilitated Learning (EFL) Level 1 US Application Form

Applicant Name *

First

Last

Email *

Date of Birth *

mm/dd/yyyy

Gender *

Male
Female
Non-binary
Other

Date of Application *

mm/dd/yyyy

Address *

City *

State/Province/Country *

Country *

Zip/Postal Code *

Phone Number *

My preferred payment method is: *

$1400 Full Tuition Upfront
Pay Per Module - $500 Per Module
I am eligible for the Discounted Rate (Student): $1150 Full Tuition Upfront
I am eligible for the Discounted Rate (Student): Pay Per Module - $400 Per Module
I am eligible for the Discounted Rate (DEI*, PATH International, Veterans/Military Personnel): $1150 Full Tuition Upfront
I am eligible for the Discounted Rate (DEI*, PATH International, Veterans/Military Personnel): Pay Per Module - $400 Per Module
I am eligible for myCAA funding

*The Diversity, Equity, and Inclusion (DEI) Discount is eligible for all BIPOC folks.

Degrees and Qualifications Held: *

Please list title of degree, institution, and/or certifying body

Post-Graduate and/or Additional Training Experience(s): *

Please list year, length of program, name of program

What attracts you to The HERD Institute? *

Please describe your experience with horses (please include any riding experience) *

What is your current understanding of Equine-Facilitated Learning (EFL)? *

What do you hope to gain from this training? *

Please provide a Personal Statement about yourself and your experience *

Do you have any special needs or dietary requirements, while you are at the training? (Please check all that apply) *

Please use this space to provide any further information you feel may be relevant *

Please email a copy of your most current resumé to [email protected] *

I have emailed my resumé
I do not have a current resumé so will email one within the next 5 days
Other

Declaration *

DECLARATION: By typing my name in the Applicant Electronic Signature box above, I declare that all the information I have provided is true and complete to the best of my knowledge and that The HERD Institute has my permission to obtain all necessary information from the references I have listed concerning my past experience and I release all parties from any possible damages resulting from disclosing such information with or without prior written notice from me. I understand that this application does not constitute a contract of any kind. Should the HERD Institute enroll me, I may terminate such enrollment at any time. I have read and agree to the above statement and understand that by entering my name, I agree to the terms.

+1 (802) 823 2888

[email protected]

The Human-Equine Relational Development Institute

Equine-Facilitated Learning (EFL) Level One Application Form