EmailMe Form - 2017 ORIS FARM AND FOOD LEADER APPLICATION

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APPLICANT INFORMATION
Name
First Last
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Date of Birth
MM / DD / YYYY
Phone
### - ### - ####
Cell Phone
### - ### - ####
Email *
Have you ever been convicted of a felony? *
Yes
No
AVAILABILITY
The Farm & Food Leader Program is an eight week program that runs July through August. Below are the times when we will require intern staff. Please check each time frame that you are available for.
Please choose which session you are available for (CHECK ALL THAT APPLY): *
Mondays from 10 am - 2 pm
Tuesdays from 10 am - 2pm
Wednesdays from 10 am - 2pm
Thursdays from 2:30 - 6:30 pm
INTERESTS
Our Farm & Food Leader Program is designed to teach career success, leadership skills, team building and more. Leaders will learn a great deal about how to grow food and bring it into the local community, and the benefits of doing so.
Why are you interested in becoming a Farm & Food Leader? *
Please CHOOSE THE TOP FIVE boxes next to the areas that interest you the most: *
Becoming a Farmer
Working Outdoors
Friends & Community
Working on a Farm
Managing Soil Health
Pest Control & Problem Solving
Managing Watering Systems
Farmers Markets
Running a Farm Stand
Crop Care & Maintenance
Food Justice
Analyzing Food Prices and Sales Levels
Social Media & Internet Marketing
Cooking/Recipes
Food in Restaurants
Food in Hospitals
Studying Food Systems
Going to College
Solving Hunger
Food Banks & Food Pantries
Business Marketing
Business Management
Health & Wellness
None of the above
Other
WORK & VOLUNTEER EXPERIENCE/SKILLS
Current or most recent place of paid employment:
Current or most recent volunteer positions:
Current employment status:
Full time
Part time
Not employed
Volunteer
Work performed at these places of employment and/or volunteer positions:
Do you speak any other languages? *
Fluent?
Semi-Fluent?
Basic?
Please list any skills or experience that you feel are pertinent to becoming a Farm & Food Leader: *
EDUCATION
If you are currently enrolled in school, please list the school name here:
Do you have a focus of study? Are you enrolled in vocational or specialty courses? If so, please list them.
What is your current level of education?
High School Freshman
High School Sophomore
High School Junior
High School Senior
College Freshman
Other
PERSONAL INFORMATION
Have you participated in our program, or other farm programs in the past? Please describe:
What specific experience would you like to gain through this internship? *
Describe your long-term career goals: *
SIGNATURE (PLEASE DO NOT LEAVE BLANK!):
By typing your name in this box, you certify that your answers are true and complete to the best of your knowledge. If this application leads to an internship assignment, I understand that false or misleading information in my application may result in my release. *
This is your basic application. Once you click SUBMIT, you will be taken to the second part of the application which asks for a PERSONAL REFERENCE. Please have your personal reference (an individual who knows you, other than a family member) complete the next page of this form.

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APPLICANT INFORMATION

AVAILABILITY

INTERESTS

WORK & VOLUNTEER EXPERIENCE/SKILLS

EDUCATION

PERSONAL INFORMATION

This is your basic application. Once you click SUBMIT, you will be taken to the second part of the application which asks for a PERSONAL REFERENCE. Please have your personal reference (an individual who knows you, other than a family member) complete the next page of this form.