Application Form for ELPO Eight Week Farrier Course

Full Name (Printed)_____________________­­­_______________________________________________

Social Security Number:   ______ - _____ - _________  (used for background check and medical emergencies) 

Home Address________________________________________________________________________

____________________________________________________________________________________

Mailing address (if different) ____________________________________________________________

____________________________________________________________________________________

Phone 1___________________________Phone 2 (or e-mail):__________________________________

Start Date of Course you would like to attend?:_____________________________

Over 18?    Yes_______ No______

Due to transportation and other liability limitations, no one under 18 years  of  age can be accepted unless attending with a paid parent. No one under age 16 will be accepted under any circumstances.

Brief description of applicant’s Horse experience:

____________________________________________________________________________________________

____________________________________________________________________________________________

Immediate expectations after completing the course (why are you taking the course?):

____________________________________________________________________________________________

____________________________________________________________________________________________

Long term expectations: _________________________________________________________________________

_____________________________________________________________________________________________

I understand that NO DOGS are allowed. No smoking is allowed in class.  Students are responsible for their own transportation & housing.  We can provide you with housing recommendations. I have read the enclosed tuition and payment terms, and the course description.

I have enclosed a non refundable deposit /application fee of $500.00,   to be applied toward tuition upon acceptance.  

Enclosed check:     Check# ____________Amount $______________________________

Credit Card: _________­__-____­­­______-__________-_________Exp. Date: ____/____ Security Code:_____

Credit Card Holder’s Signature:_________________________________________________________

Applicant’s Signature _______________________________________________Date_____________

You will be contacted by the instructor for a brief telephone interview soon after receipt of application and deposit. Upon acceptance of your admission, you will receive an invoice for balance of $5,500.00

Make Checks Payable to:  E.L.P.O Inc.

Send Application Form and Deposit to:

Equine Lameness Prevention Organization, Inc.

P.O. Box 674

Penrose, CO  81240