Social and Therapeutic Horticulture Facilitator Training Programme Application Form

Name*

First Last

Country*

Street Address*

Address Line 2

City \ Town*

County*

Postal Code*

Email*

Enter Email Confirm Email

Mobile Number*

Is English your first Language?

PPS Number \ UK National Insurance Number needed for QQI records*

Date of Birth*

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.*

Description of your experience with the above groups*

What is your experience with horticulture?*

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

Broad outline of responsibilities:*

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?*

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

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