Leader in Learning Application

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Age*

Grade*

School*

How will you be transported to the farm?*

Weight over 200 lbs?*

Are you physically fit?*

Please list any allergies and/or health concerns.

Please state your family physician and contact information.

Please list your emergency contact and their phone number.

Please list your health insurance carrier, policy number and contact information.

Do you have a current first aid/CPR card?*

Please list any other certifications held.

What is your equine experience?

What is your prior farm or ranch experience?

In what team sports or activities do you participate? What is your role?

What types of outdoor activities do you enjoy?

Do you have a job? If so, what is it?

What types of chores are you asked to do at home?

What types of work do you enjoy?

What kind of experience do you have working with children?

Please describe your experience(s) working with people who have special needs.

What kinds of things make you happy?

What are your hobbies?

Which animals do you enjoy being around?

Please list ONE reference, not related to you, their significance in your life, and their contact information*

Why do you want to be a Leader-in-Learning at Sunnyside Farms?*

Would you consider yourself introverted or extroverted?*

How much time and which weeks of the summer are you most interested in being a leader?*

What would you would like to achieve by being a Leader at Sunnyside?*

Who is a hero to you and why?*

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Leader-In-Learning Application