Athena Equine Assisted Services Application

Application

About You

Title

Name *

First

Last Name *

Last

Email *

Phone

Address

City

State/Province

Zip/Postal

Country

Which Course are you applying for?

Website URL (optional)

What is your current job/profession?

Do you have any professional qualifications?

Are you a member of any Professional Bodies or Accrediting Organisations?

Do you have a business name to place on invoices?

Yes

Please give details (please only enter the Company Name here)

Address

City

State/Province

Zip/Postal

Country

Do you have any dietary requirements or allergies that we need to be aware of?

Previous experience or interest in Equine Facilitated work:

Have you ever been involved with Equine Assisted learning or therapy in the past? Was this as a practitioner or participant?

Have you ever worked as a EAS Practitioner?

Yes

With which Organisation, and with what client group?

If you have already received training or completed a Qualification, who was this with and to what level?

Can you tell us about your experience of handling horses or other animals? Have you owned or worked with horses for instance (it is not an essential requirement but helps us to understand your learning needs)?

Please tell us about your interest in signing up to our Level 2 Certificate or Level 4 Diploma, and how you envisage using the Certificate/Diploma in the future

Is there anything else you would like to share with us to support your application?

I would like to submit my application to Athena Herd Foundation CIC for consideration and approval. I understand that if my application for the next cohort is accepted, I will be required to pay the advised non- refundable deposit to secure my place. By paying this deposit you will be deemed to have accepted the terms and conditions set out on our website athenaherd.org

Which course dates are you interested in?

Which course dates are you interested in (use this entry if you are struggling to use the above drop down or do not yet know)?

I Agree

Date

Emergency Contacts

Emergency contact first name

Emergency contact last name

Phone

If you are human, leave this field blank.

About You

Previous experience or interest in Equine Facilitated work:

Emergency Contacts

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