Instructor Training Registration Form

Instructor Training Registration Form

Fill out the form carefully for registration
Student Name *

First Name Middle Name Last Name
Birth Date *

Month Day Year
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Phone Number *

Area Code Phone Number
Course Location and Date *
Please choose one of the following: *
Size *
Have you taken an equine first aid or other medical related equine courses before? *
Are you capable of being on your feet in an often physical capacity for at least 7 hours at a time? *
Tell us about your equine experience. *
What is your plan to promote courses and grow your new business? *
What does teaching equine first aid mean to you? *
Please upload a video - 2 minutes or less - explaining why you thing you would be an asset to the Equi-Health Team.

Choose a File

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The tuition is $2999 including tax. Choose your method of payment. Your payment will not be processed unless accepted. *
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