Seven Springs Farm
Apprentice Application 2008
426 Jerry Ln. NE.
Check, Va. 24072
Phone (540) 651-3228

NAME: ______________________________________                 YOUR AGE: ______________________
ADDRESS:___________________________________                  PHONE #:________________________
_____________________________________________                 DATE OF BIRTH: _________________
EMAIL ADDRESS PLEASE PRINT:__________________________________________

ARE YOU A CIGARETTE SMOKER :_______               MALE __ / FEMALE __

DO YOU DRIVE A STICK SHIFT: _________________________________________________________

AT PRESENT OR IN THE PAST HAVE YOU EVER HAD ANY SERIOUS BACK, KNEE
OR OTHER HEALTH PROBLEMS WE SHOULD KNOW ABOUT:
_______________________________________________________________________________________

IN CASE OF EMERGENCY WHO WOULD YOU LIKE US TO CONTACT:
NAME: __________________________ HOME PHONE #: _________________
RELATIONSHIP:__________________ WORK PHONE #: _________________
ADDRESS: ________________________________________________________

WHAT TYPE OF EXPERIENCES DO YOU HAVE WORKING IN THIS OR OTHER RELATED
FIELDS:
________________________________________________________________________________________
________________________________________________________________________________________
_____________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

CAN YOU DESCRIBE HOW YOU PLAN TO UTILIZE THE INFORMATION & EXPERIENCES
YOU LEARN DURING THIS PROGRAM. EXAMPLE: THE TYPES OF WORK YOU HOPE TO
PERFORM IN THE FUTURE USING THIS KNOWLEDGE OR THE TYPES OF THINGS YOU
HOPE TO TEACH AND SHARE.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

 WHAT ARE YOUR INTERESTS IN THIS OR RELATED FIELDS:
_______________________________________________________________________________________
_______________________________________________________________________________________

ARE YOU PHYSICALLY FIT, HOW DO YOU STAY IN SHAPE:________________________________
_______________________________________________________________________________________

ARE YOU INTERESTED/CONFIDENT/ OR WILLING TO LEARN THE USE OF SOME POWER EQUIPMENT ON THE FARM, SUCH AS WEEDEATER, CHAIN SAW, TRACTOR:________________
 ______________________________________________________________________________________
 ______________________________________________________________________________________

WHAT IS THE TIME FRAME THAT YOU ARE AVAILABLE TO WORK IN 2008?
FROM WHEN TO WHEN?
_______________________________________________________________________________________

DO YOU HAVE YOUR OWN TRANSPORTATION: (not required)  ______________________________



REFERENCES

#1 NAME ___________________________________
PHONE_____________________________________
ADDRESS__________________________________
___________________________________________
EMAIL_____________________________________
TYPE OF RELATIONSHIP WITH THIS PERSON :
_______________________________________________________________________________________
_______________________________________________________________________________________
TYPE OF WORK PERFORMED WITH THIS PERSON (if applicable):
_______________________________________________________________________________________
_______________________________________________________________________________________

#2 NAME ___________________________________
PHONE_____________________________________
ADDRESS__________________________________
___________________________________________
EMAIL_____________________________________
TYPE OF RELATIONSHIP WITH THIS PERSON :
_______________________________________________________________________________________
_______________________________________________________________________________________
TYPE OF WORK PERFORMED WITH THIS PERSON (if applicable):
_______________________________________________________________________________________
_______________________________________________________________________________________

#3 NAME ___________________________________
PHONE_____________________________________
ADDRESS__________________________________
___________________________________________
EMAIL_____________________________________
TYPE OF RELATIONSHIP WITH THIS PERSON :
_______________________________________________________________________________________
_______________________________________________________________________________________
TYPE OF WORK PERFORMED WITH THIS PERSON (if applicable):
_______________________________________________________________________________________
_______________________________________________________________________________________

PLEASE MAY ATTACH A RESUME WITH THIS APPLICATION IF YOU LIKE.
YOUR INFORMATION IS CONFIDENTIAL WITH SEVEN SPRINGS FARM. THANKS.