Last Name *

First Name *

Please list your nickname, preferred pronoun or anything else the farm crew should know about you here.

Primary Email Address *

Primary Phone # *

Street Address and Zip code (this is solely for carpool purposes)

Parent/Guardian Name- Primary contact *

Parent/ Guardian Phone # *

Parent/ Guardian Email Address *

Emergency Contact Name *

Emergency Contact Phone # *

Do you have any allergies or disabilities that the farm should no about? (i.e. bee allergies, pollen allergies, depression, etc) Are you taking medication that could impact your performance or cause reaction when exerting yourself physically in a hot environment. This information will only be shared as is necessary to ensure safety. *

Are you willing to abide by all COVID 19 precautions such as mask wearing, social distancing and frequent hand washing taken on the farm and sign a wavier indicating that you will not hold the farm liable for acquiring COVID 19 unless gross negligence is demonstrated? *

Why do you want to work on a farm? Why are you interested in agriculture?

What unique abilities or characteristics do you possess that should be considered?

What should The Farm at Our House know about your work habits and communication skills?

What characteristics are you looking for in a supervisor?

Do you have a driver's license? Can you drive others legally?

What other unique skills or characteristics do you possess that you think would contribute to the farm? (i.e. photography, videography, social media prowess, etc.)