Professional Herbalist Training Program Application

 

I certify that the information recorded in this application and all other application submissions are true and correct. Otherwise, I understand that I may be dismissed from the School.
Basic Information
Note: We will never share your private information
Background
The following information is optional, but please provide all that you can.
Please include high school, college, and herbal education
From-To / Degree / Date Received
What college level science classes have you taken?
Please describe your Employer / Your Title / Job Duties / Hrs per wk / Length of Employment
Do you plan to work while attending the PHT program?
What length of time have you had this Job?
Both the PHT Program and the Clinical Case Studies Program are demanding of one’s time and energy. If you apply and are accepted, are you prepared to make the commitment needed to be successful in the program?
Please provide the following information
Emergency Contact Information
In the unfortunate case of an emergency, please include the name, number, and address of two people may be contacted, as well as your relationship to each person.
First Contact
Second Contact
References
Please include the phone numbers of three to four work related and/or personal references. All information is kept confidential.
First Reference
Please input the best way to get in touch with your reference. This must be the phone number of email address of your reference.
Second Reference
Please input the best way to get in touch with your reference. This must be the phone number of email address of your reference.
Third Reference
Please input the best way to get in touch with your reference. This must be the phone number of email address of your reference.
Fourth Reference (optional)
Please input the best way to get in touch with your reference. This must be the phone number of email address of your reference.
Files must be less than 5 MB.
Allowed file types: txt rtf pdf doc docx.
Files must be less than 2 MB.
Allowed file types: txt rtf pdf doc docx.