Submit~ Therapeutic Riding Instructor Application

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Please check all CURRENT Certifications that apply*
- PATH Therapeutic Riding Instructor
- PATH Therapeutic Driving Instructor
- PATH Equine Specialist in Mental Health
- PATH Interactive Vaulting Certification
- CPR & First Aid Certification
- EGLA
- EAL Certified
- Stable Moments Certification
PATH Certification Membership Number*
How many years experience do you have as a therapeutic riding instructor*
Please enter a number from 1 to 40.
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Employment History