Appalachia School of Holistic Herbalism

  • slideshow image
  • slideshow image
  • slideshow image
  • slideshow image
  • slideshow image

Application form

FOR CERTIFICATION COURSES ONLY – No application needed for short workshops!

Name *

DOB *

Address *

City *

State*

Zip*

Phone*

Email *

Best way to be Reached:*

Current occupation:

In case of emergency notify:*

Relation:*

Phone:*

Program Applied For*

How do you plan to finance your tuition and training expenses?

Education History

Have you had any prior training or work experience in Plant Energies or Herbalism?

Describe any mental or physical conditions that might affect your participation in the program:

What interests you most about this program?

Where did you hear about us? (Please be specific)

Upon acceptance, you will be asked to sign a waiver and/or enrollment contract and make a tuition
deposit to secure your spot in class.