Host Application
Fields marked with an * are required.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
I understand the requirements for hosting an Equine First Aid Clinic found here: https://equinefirstaidclinics.com/hosting-a-clinic
*
Yes
What clinic are you interested in hosting?
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Equine First Aid Fundamentals 1/2 Day Clinic
Equine Emergency First Aid Clinic (most popular/prerequisite for Advanced Clinic)
Advanced Equine First Aid
When would you like to Host a Clinic?
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-
Month
-
Day
Year
Date
Where will the clinic be held? (Boarding Facility, Equine Rescue, Private Home, etc.)
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Website / Social Media (type n/a if not applicable)
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How many "patient" horses do you have available?
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What type of area with electricity do you have available for the PowerPoint portion of the clinic? Please describe.
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What type of area do you have available for the hands-on portion of the clinic? Please describe.
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Do you have a bathroom facility available for students?
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Do you already have people ready to enroll in an equine first aid clinic?
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Yes
No
Are you willing to promote the clinic locally?
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Yes
No
Give us an idea of how you will promote the clinic: riding clubs, website, Facebook page, local newspaper, tack store, feed supply, etc.
*
Please select all that apply:
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"Patient" Horses Available
Area with Shade to Work with Horses
Covered Area for Rain or Snow to Work with Horses
Area with Seating and Electricity
Area to Eat Lunch
Comments or anything you would like to share:
Please verify that you are human
*
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