Herbal
Therapeutics Two-year Training Program Application
2006-2008
Name:__________________________________________________________________
Address:________________________________________________City:_________________State:________Zip:_______________
Phone:__________________Work:_____________________
E-Mail:_______________________________ DOB: ______________
Social Security
#:_________________________
***********************************************************************
If you need more space please
attach a second sheet with reference to the question asked.
1. Why do you want to attend
this course? Please attach a typed or neatly handwritten essay.
How do you plan to use the
information gained from this course?
___________________________________________________________________________________________________________
2. How did you hear about the
Herbal Therapeutics
program?__________________________________________________________
3. Were you referred by
someone? If so, any letter of recommendation should be included with
4. What is your background in
herbal medicine and how long have you been interested in it?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
5. Have you studied other
allied topics? (Nutrition, Bodywork, Flower Essences, Reiki, Homeopathy, etc.) and with
whom? Please attach copies of any certificates or degrees.
______________________________________________________________________________________________________________________________________________________________________________________________________________________
6. Have you had the
prerequisite class: College Level Anatomy & Physiology?_____
____
If yes, please include a
photocopy of your transcript. If not, are you enrolled in a current class?
List location and name of
school: ________________________________________________________________________
7. Do you have any medical
training? (MD, RN, OMD, RD, ND, DC, etc.) Please include a CV of your education
and
practice.____________________________________________________________________________________________________
8. This program requires a two
year commitment (*time & financial). We regularly have over 70 applicants
for only 28 seats. Are there any situations (grad school, career, family,
health, etc.) that would prevent you from making this commitment?
__________________________________
________________________________
_________________________________________________________________________
9. In addition to class time
all students are expected to do supplemental reading, case histories,
diagnostics practice and **2 Class Projects (1 per year). You can expect that in
addition to 5 hours classroom time, you will need an additional 10-15 hours per
week to successfully do required work. Are you able to do
this?______________________________________________________________
10. The cost for the 2 year
program is $2250.00-$2500.00 per year depending on payment method.
Total tuition cost for two years is $4500.00-$5000.00. Student loans
(State/Federal) are not available for this program. Can you commit to the
financial responsibilities involved?
______ ___
*The Herbal Therapeutics
Program meets 43-45 weeks out of 52 per year (5:00pm-10:00pm).
Excessive absence (more than 7 in one year) or chronic tardiness may
result in dismissal from the program.
**Class projects are extensive
projects that are chosen by the student and David Winston.
They may include written work (40-60 pages typed), demonstration, videos,
slides, lecture, etc.
Please return with a stamped, self-addressed envelope (SASE)
Herbal
Therapeutics School of Botanical Medicine
P.O. Box 553
Broadway, NJ 08808
(908) 835-0822 (908)
835-0824 FAX
classes@herbaltherapeutics.net