Equine Assisted Learning Facilitator Training Programme Application Form

Name*

First Last

Street Address*

Address Line 2

City \ Town*

County

Postal Code

Country*

Email*

Enter Email Confirm Email

Mobile Number*

Gender*

PPS Number*

Date of Birth*

Emergency Contact Details

Emergency Contact Name*

First Last

Emergency Contact Phone*

Emergency Contact Address

If same as your address you may leave this blank

Street Address Address Line 2 City \ Town County Postal Code Country

Qualifications & Experience

Please list all your qualifications:*

Do you have experience of working with any of these groups? If so, please select and describe below.*

Children aged 1-10yrs
Young People aged 11-19 years
Adults
People on the Autism Spectrum
Job Seekers
Those with drug or alcohol misuse
People with learning difficulties
Young people with social, emotional or behavioural difficulties
Offenders / Ex-Offenders

Description of your experience with the above groups*

What is your experience with horses?*

Do you have any horse handling qualifications?*

Currently Employed?*

Name of Current \ Last Employer*

Date Employment Commenced

Date Employment Finished

Please provide details of current employment and relevant work experience (if any):*

Broad outline of responsibilities:*

Relevant Work Experience (if any):*

Please tell us how you would envisage using the skills and knowledge you will gain from this Training Programme:*

Please provide some information as to why you feel you would be a good candidate for this course:*

What is your main interest in participating in this Training Programme?*

Please use this space to tell us anything else about yourself e.g. skills, experience etc. in relation to participating in this Training Programme:*

How did you hear about this course?*

Festina Lente Website
Festina Lente Facebook
Festina Lente Newsletter
I heard about you from family & friends
I saw an advertisement online
I saw a printed advertisement
Other

Do you give permission for any photos taken by staff to be used for Festina Lente purposes (Website, Social Media etc)?**

Yes
No

Would you like to join our mailing list?

Yes
No

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Equine Assisted Learning Facilitator Training Programme Application Form