Appendix 3 Betonica Herbal Apprenticeship Application Form - 2017

Appendix 3 Betonica Herbal Apprenticeship Application Form - 2017

Appendix 3 – Betonica Herbal Apprenticeship Application form - 2017

Name:
DOB:
Address:
Telephone number(s):
Email address:
Education / (Please include name of institution and grades achieved)
Secondary education
College/Sixth form
University
  1. Previous Work experience

Current employer and job role
Start date
Employer and job role
Start date
End Date
Employer and job role
Start date
End Date
Employer and job role
Start date
End Date
  1. Additional skills or experience
/ Please list any additional skills or experience that you feel may be relevant
  1. Please describe, in under 150 words, why you would like to take part in the Betonica Herbal Apprenticeship programme?

  1. Please explain, in under 150 words, what you would do once qualified as a medical herbalist?

  1. Is English your first language? Y / N
  1. If not, do you have an IELTS level 7 or equivalent qualification in English? Y / N

  1. References
/ Please give the names and addresses of two referees.
Referees can be previous employers, colleagues in projects you volunteer at, previous course tutors etc. They must have known you for at least 2 years.
Referee 1
Name
Address
Email address
Telephone no.
Referee 2
Name
Address
Email address
Telephone no.
  1. Do you have any health conditions that may affect your ability to complete the course?
  1. Do you have any special dietary requirements?
  1. Name and telephone number of person to contact in an emergency

Do you have any specific learning needs?

  1. Do you require any adapted materials?

E.g. Dyslexia – print needed in Arial font size 14 on green paper.

Or those who are visually impaired may need large print and no OHP.

  1. Which year of the apprenticeship are you applying to join?

Year 1

Year 2

Year 2

(but willing to be added to the Year 1 list if a Year 2 place is not available)

  1. If you’re applying to Year 2 please complete sections 14.

If you’re applying to Year 1 please go to section 15.

  1. Please complete the following table regarding the prerequisites for Year 2.

Prerequisite / Please provide a list of the courses/workshops you have attended and with whom.
Anatomy and physiology
(at A level or equivalent level or higher) / Please provide a certificate and a link to the course content so that we can assess if additional study is required.
6 days contact time with a medical herbalist
This can be workshops or longer courses but must be within the last 5 years (and must be ‘in person’ days). / Day 1 –(date) (subject) (herbalist)
Day 2 –(date) (subject) (herbalist)
Day 3 –(date) (subject) (herbalist)
Day 4 –(date) (subject) (herbalist)
Day 5 –(date) (subject) (herbalist)
Day 6 –(date) (subject) (herbalist)
Study of herbs
In the first year of the apprenticeship 50 herbs are studied. / Please provide details of any herbs that you have studied, either self-study, online courses or in person courses.

Please note: If you are not able to meet all of the prerequisites we can provide information on courses that would be accepted, and we also have our own. These would need to be completed by the end of August 2017, and have an additional cost.

  1. Please send your completed application form to .

We will let you know via email by Friday 5th May 2017 if you have been shortlisted for an interview.

Interviews will take place on Saturday 13th May 2017 (location to be confirmed).

Please note: all of your information will be kept in accordance with the Data Protection Act.

Betonica Herbal Apprenticeship Prospectus Updated 17.11.16 1

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