Eclectic School of Herbal Medicine
Clinical Intensive Program
Application Form
Personal Information
Name:
Address:
Phone:
Email:
Tell us a little bit about yourself.
What experiences have you had in the field of herbalism, including past studies?
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How did you hear about the Eclectic School of Herbal Medicine? And what made you
choose to apply for our clinical program?
Can you make a solid 11-month commitment to our program? Including the time and
financial responsibilities involved in such an opportunity? Are you prepared for the
intense studies one must undertaking during this program?
What would you like to achieve through this intensive program?
Our program is an 11-month live-in program located at Wellspring Mountain. We offer
limited shared and private lodging but also welcome commuters. Where do you plan on
living throughout the course of your studies?
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Phone Interview:
To complete your application into our clinical intensive program, we will need to conduct a
phone interview. Please list days and times you are available on a weekly basis for us to call.
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Deposit and Tuition Information:
Tuition and lodging costs are due two weeks prior to start of the program, unless you have
prearranged a payment plan with us. There are a limited number of spots in our program. To
ensure your place there will be a $500 deposit. Once you are accepted and this deposit has
been received, it will be non-refundable.
Please return application to:
671 Ramey Orchard Rd., Lowgap, NC, 27024 or email to Lindsey@WellspringMountain.com
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