REINS CTRI-IT Mentorship Interest Form

REINS CTRI-IT Mentorship Interest Form

Thanks for your interest in our CTRI Mentorship program! Let us know a little about you:
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Disability Education
Experience*

3<5+ years2<2+ years1<1+ years0<0 years
How would you describe your experience with those with disabilities? In completing your rating, please consider: Do you have experience working with a diverse disabled community? Are you familiar with a wide range of disabilities and their medical needs and complications? Are you familiar with industry wide standard language and terminology?*

ExcellentGoodFairPoorVery Poor
Please describe your experience, you may provide references:*
Equine Handling
Experience*

3<5+ years2<2+ years1<1+ years0<0 years
How would you rate your equine handling ability? In your rating, please consider: Have you had formal education on the safe handling of equines? Are you able to catch, lead, groom, and tack an equine safely? Are you familiar with basic equine anatomy and first aid? Are you comfortable reading and interpreting equine body language?*

ExcellentGoodFairPoorVery Poor
Please describe your experience, you may provide references:*
Riding Ability
Experience*

3<5+ years2<2+ years1<1+ years0<0 years
How would you rate your riding ability? In your rating please consider: Are you able to safely mount and dismount a horse? Are you able to safely maneuver a horse at all gaits? Are you safely able to transition a horse to all gaits? Are you able to describe and perform: bend, half halts, leg yields? Are you able to distinguish diagonals and leads?*

ExcellentGoodFairPoorVery Poor
Please describe your experience. You may provide references:*
Therapy Riding (TR) Experience
Experience*

3<5+ years2<2+ years1<1+ years0<0 years
Have you volunteered at REINS or another TR barn?*

NoYes
If yes, where and how long?*
Please rate your comfort in a Therapy Riding environment? In your rating please consider: Have you volunteered or instructed at another TR barn? Are you comfortable and familiar with industry standards? Are you familiar with PATH International? Are you familiar with the CTRI process?*

ExcellentGoodFairPoorVery Poor
Please describe your experience. You may provide references:*
How did you hear about REINS?
Signature*
Thank you so much for taking the time to fill out this form!
A REINS representative will reach out after receiving and reviewing the information you've provided.
Should be Empty:

REINS CTRI-IT Mentorship Interest Form

Disability Education

Equine Handling

Riding Ability

Therapy Riding (TR) Experience