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?*

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

Do you have prior Experience with Animals?*

Please list ONE reference, not related to you & their contact information*

Why do you want to Intern on the Farm?*

What weeks of the summer are you most interested in being an intern?*

Any other people/animals in your life that need accommodation?*

Live-In position requested?*

Who is a hero to you and why?*

Leader-In-Learning Application