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THE ANIMAL INSTITUTE OF HOLISTIC HEALTH™ Bennie Jean Kuehnle, Director Rt 1 Box 98 Marietta, OK 73448 (580) 276-9811 Ranch (580) 276-0101 Cell petspeak@swbell.net www.theanimalinstitute.com
ANIMAL THERAPY APPRENTICESHIP PROGRAM APPLICATION
Date ____________________________ Name ________________________________________________
Address ______________________________________________
City ____________________________________ State ______ Zip _________
Phone (Day) ___________________________ (Evening) __________________________
Current Occupation ______________________________________________________________________________________
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Education/Training _______________________________________________________________________________________
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Previous Experience with Horses/Other Animals ____________________________________________________________
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Explain your interest in this type of career _________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________
How were you referred to the school? ___________________________________________________)_________________ _________________________________________________________________________________________________________
Working on animals, both large and small, requires dedication, determination and patience. This course is both mentally and physically demanding, covering a great deal of information and requiring lots of hands-on work with animals. Do you have any concerns that we should be aware of? Any physical limitations? ______________________________________________________________________________________________________________________________________________
You will receive a certificate of completion stating that you have successfully completed this intensive course and are performing with the high standard of excellence and integrity of this institution, which serves the best interest of the animal. The work of this school enhances and supports sound veterinary care.
I certify that to the best of my knowledge, I am in good health and capable of participating in the program.
RELEASE OF LIABILITY: I release and hold harmless The Animal Institute of Holistic Health™ and their agents from any liability due to accident or damage to self, horse, small animal and/or personal, and from loss during the training course. Signed and Witnessed.
Signed ______________________________________ Date ________________
Witness _____________________________________
Additional information or comments __________________________________________________
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