Level 3 Program Application Form

Name

First NameLast Name

Email

example@example.com

Iname successfully completed the level 2 course on date on certificate .

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Please describe your herbal education to date. This includes prior, current and future herbal school training including the length of time.

How would you describe your commitment during the Level 2 Program?

What sparked your interest in the level 3 program?

How have you evolved since completing the level 2 program?

What is your experience with human anatomy?

List all herbal books that you rely on.

What do you desire to do with the knowledge obtained during the level 3 program?

How would you use the knowledge to change the narrative within your community?

How much time are you willing to devote to the course?

Are you willing to purchase necessary tools to complete the program?

Do you have any schedule conflicts that will cause you to miss live class Wednesday's at 7:00PM EST?

I understand that I must be present for all classes and my camera must be on.

If you are accepted into the program are you willing to the complete all work by the assigned deadline?

What tools or skills do you hope to gain from this program?

I understand the importance of showing up for myself. If accepted into the program I will fully committed to the process.

I blanks understand the importance of showing up for myself. If accepted into the program I am fully committed to the process.

I blanks understand that all payments are nonrefundable and may be transferred to future class.

I understand class prices start at $899 and payment plans are available.

Did someone refer you to us? If so, please include their name!

Signature