LOST VALLEY INTERNSHIP APPLICATION
Today's Date _____________________________________________
Name ___________________________________________________
Address _________________________________________________
City _________________________ State _______ Zip____________
Day phone ________________ Eve phone ______________________
E-mail Address ____________________________________________
Date of Birth ____________________________
Internship for which you are applying ____________________________
Requested internship dates (start and end, be specific):________________________
Where did you find out about our internships? (please list specific website or person) ___________________________________________________________
How did you learn about Lost Valley Educational Center? _______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What skills/qualities/knowledge would you like to acquire or develop through being at Lost Valley? _______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
How do you see your prior work and life experience contributing to your work at Lost Valley?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Some of the work you may do entails continuous and sometimes strenuous physical activity. Do you have any experience with work of this nature? _______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
What skills or passions do you have that you would like to share with other interns and staff at Lost Valley?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Interns will be living in an intentional community and interacting daily with community members. Have you ever lived communally? How do you feel about living in an intentional community, and what challenges do you expect to come up for you?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
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? _______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Our internships require high levels of self-discipline and initiative. Describe a recent experience where you demonstrated these qualities.
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Do you have any health problems, special needs or addictions? _______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
How do you see your role in creating a sustainable world culture? _______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Our internships require some work on weekends as part of weekly work hours. Are you open to working on weekends as needed?
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Is there anything else that you think we should know, or that you would like us to know about you? _______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Please include a resume specific to your requested internship and 3 work-related references, and send or email to:
Internship Coordinator
Lost Valley Educational Center
81868 Lost Valley Lane
Dexter, OR 97431
Phone: 541-937-3351 x102 Email: intern_at_lostvalley.org [1] Web: www.lostvalley.org