Work Study Service Application 2017
Your full name (as listed on passport)
Your answer
passport number
we keep on hand in case of emergency only
Your answer
Country of residence (as listed on passport)
Your answer
your email address
we do not share your information with others.
Your answer
Your facebook URL link
Your answer
emergency contact: name, email, phone number (with country code and area code)
Your answer
What is your vision for this world?
What inspires you and motivates you?
Your answer
How do you uphold you life vision with action?
For example: I am an advocate for ecology, and even though I don't have a garden, I only buy organic food.
Your answer
What draws your interest to work with the Reviveolution?
Your answer
What skills would you like to bring to your experience here with us?
Your answer
How do you feel you can enhance our mission to bring indigenous wisdom to the modern world as an integral team member?
Your answer
How do you tend to adapt to setbacks, road bumps, or challenges?
Do you have particular practices or things you do to support you in staying relaxed and in open communication?
Your answer
On a personal level, what would you like to accomplish here?
Maybe a specific cleanse, project, goal, etc
Your answer
Do you have any specific dietary needs/preferences?
Required
Do you have any current health conditions?
If so, please explain what it is, and to what extent it affects your daily life.
Your answer
Please list any known food, plant, medical, or other ALLERGIES you have
Your answer
Please list any and all medications you are currently taking.
Pharmaceuticals, vaccines, herbs, etc
Your answer
Do you agree to uphold the Community Agreements as a practice during your stay?
Nobody is perfect. The agreement is to hold these points as anchors for interacting with ourselves and others. We ask for your communication to help us stay aligned with these agreements as well.
Required
Anything you care to share, add, or ask us?
Your answer
Would you like to join Reviveolution's mailing list?
How did you hear about us?
Your answer
What month(s) are you looking at coming?
We receive new participants the 3rd weekend of most months. And require at least a 1 month stay (though encourage 3)
Your answer
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