Email address *

Name *

Phone number *

Mailing address including postal code *

Help us get to know you as an herbalist! Are you a clinician, a traditional healer or other herbal professional, a farmer, manufacturer or formulator, an educator, a writer, a harvester or ….? Tell us in 75-100 words *

Please attach here a photo of yourself – head and shoulders *

Do you have a cultural background or practice that influences/informs your work as an herbalist? Tell us in 75-100 words *

Do you maintain a clinical or healing practice? If so, can you describe your practice and your work in 75-100 words? *

Do you have any teaching experience? If yes, can you elaborate a bit – when, where, what topics? *

Of your proposed classes, have you taught any of them before? If so, when and where? *

Do you have an online presence or social media? Please add your Facebook and Instagram and website links here. *

Can you speak comfortably on screen (to a camera)? Please add links here to any film footage available of yourself talking about herbs. *

Can you commit to submitting all required pre-recorded materials, power points and / or text notes by October 1st. *

Do you have sufficient internet speed to stream live video? *

Do you have or can you get a good quality camera and microphone to create a pre-recorded video? *

We are accepting applications for lectures of various lengths : 20 minutes pre-recorded sessions, 75 minutes live or pre-recorded lectures and panel discussions. Please indicate your preferences for each title submitted. *

Proposed Topic one : Title *

Topic one : brief description or outline (100 words) *

Topic one: 3 learning objectives *

Proposed Topic two : Title *

Topic two : brief description or outline (100 words) *

Topic two: 3 learning objectives *

Proposed Topic three : Title *

Topic three : brief description or outline (100 words) *

Topic three : 3 learning objectives *