Name: Pacific NW Herbal Studies: In Person
SKU: 4741
Availability: InStock

Description

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FIrst Name

Last Name

Email^*

Preferred Pronoun

she/her they/them he/him

Phone Number

What are you applying for

Austin Community Herbcraft Intro-Intermediate
Advanced Clinical or Herbal Educator Mentorship Course
Pacific NW Herbcraft

You will be receiving a call after your apply to make sure your placement in programs is possible

Mailing Address

Address Line 1

Address Line 2

City

State or Region

Country

Zip

Date of Birth

Emergency Contact and Phone

Do you have any applicable prior training? If so how many hours and with whom?

What do you plan to do with this training?

Do you have any personal expectations from this program?

Do you have any prior employment experience that is applicable to herbalism?

Garden Shops, Health Food Stores, Medical Training

Do you have any special areas of interest within herbal medicine?

Name 5 of your favorite plants

Do you have any special needs (allergies, differently-abled)

Please provide us with two references with names and phone numbers

All of the information above is correct and accurate to the best of my knowledge.

I understand that this is a nonrefundable deposit to hold my place in classes.  After doing so, I understand I need to pay off my program before the class starts. Everything on this form is accurate to the best of my knowledge.

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Pacific NW Herbal Studies: In Person

Description

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