Equi-First Aid USA Student Instructor Application
EquiFirst Aid East Coast Affiliate Trainer
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Company name or proposed name of business (N/A if none)
*
Which curriculum are you applying for?
Basic - Equine Health and Emergency First Aid, Advanced, Advanced Wilderness, Equine First Aid Fundamentals, I Can Help Kids class $3000
Disaster Planning and Emergency Preparedness $ 799
Safe Trailering $799
Horse and Livestock Handling for First Responders $799
Three curriculum package $4500
Four curriculum package (W/ Mare and Foal upon release) $5099
What is your personal and professional (if applicable) experience with horses? How many years have you been working with horses? Do you have medical experience human or animal? If so list your experience and whether it was under a vet's supervision or not. Please also list any formal medical or equine training you have had in the past.
*
Please give a short but specific description
Business Plan
*
Please give us a business plan or a description of how you will market your business.
Signature
*
SWAG! Upon completion of your program, you will be sent an ordering form with options for ordering USA or EAST COAST Instructor garb. Please indicate what you will be ordering (You can change your order at the time you receive the form)
Long Sleeve Shirt
T-Shirt
Vest
Jacket
Other
Where did you hear about us?
*
EquiFirst Aid East Coast Facebook Page
EquiFirst Aid East Coast Website
Equi-First Aid USA FB or Website
Facebook Groups
Host - please tell us who in the comments
Other website or source - please tell us who in the comments
A friend - please tell us who in the comments
An advertisement or referral
Comments
Anything you would like to add or comments about where you heard of us
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