D Acres of New Hampshire Application Form

Name

Date of Application (not Date of Birth!)

mm/dd/yy

*Please note that learners and employees (interns, apprentices, residents, staff) who live on-site must be at least 18 years of age*

I have read the following documents:

3042 Words about D Acres

D Acres Organizational Manual

Projects and Goals

(Please do not continue with application until you have read these documents.)

D Acres of New Hampshire has several programs that run concurrently. Please specify which position or program you are interested in.

Intern               

Preferred start date: (2008 growing season)  
  March 1 April 1 May 1 June 1 July 1 August  September 1 October 1     

Duration of stay:  (minimum 6 weeks)

Apprentice/College Credit  

Kitchen Manager

Artist-In-Residence
Paying Member of the Community    
Argentina program (approximately Oct 1-Nov 15 at D Acres, then depart for Argentina)

What are your preferred dates on the farm? (Intern candidates need not answer this question, as your preferences should be indicated above)

Please indicate the area in which you would like your primary focus to be.

Organic Gardening             

Animal Husbandry

Herbal Medicine

Sustainable Forestry

Woodworking

Culinary Arts/Hospitality    
Other (please specify)  

Please provide the following contact information:

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

Please provide the name, address and phone number of 2 persons to contact in case of an emergency:

Educational History

Work history for at least prior 3 years:

How did you find out about this project?

Please provide a brief paragraph stating your goal/s in joining D Acres of New Hampshire. We would also be interested in knowing of any prior study or work experience you feel will enhance your ability to function within this community.

Describe the type of farm experience and skills in which you are most interested.

Please list three interesting things about yourself:

Please list three things you want people to know about living with you:

What do you perceive will be your reaction to living and learning with a constant flow of new and unknown people in a rural area?

Everyone living at D Acres of NH is required to contribute to the functioning of the community through the communal contract.  This includes cooking, cleaning and community meetings.  Please inform us of any objections that you may have to this part of communal living.

Are you aware that fees may apply to the program you are applying to?  [Note: If you are invited to join us for an internship, apprenticeship or study abroad program, you will be asked to send in a deposit to hold your place.  Please do not send money until requested to do so.  Thanks!]

You will be in an environment where you will have the opportunity to look at and take responsibility for your own behavior patterns.  How committed are you to utilize this opportunity?

Do you have personal transportation?

Do you have special dietary needs? Please explain:

Do you have any health problems, special needs, addictions (e.g. coffee, cigarettes, alcohol), allergies?  Do you take any medications?  Please specify.

Please provide the names of at least two references, including name, title, phone and e-mail address...one personal and one employer or faculty: