Name:

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Emergency Contact Name and Phone Number:

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I am applying for:

Intern Program Summer Session Intern Program Fall Session Intern Program Winter Session WWOOF Projects Volunteer Projects Community Membership

Please complete the following questions with complete honesty.  The questions are for your own growth, not to impress anyone. Please write slowly and clearly.  Every question must be answered.

Who are you?

What do you like?

What do you dislike?

What are your strengths?

What are your weaknesses?

If you had all the money you would ever need or want, how would you spend your time on Planet Earth?

What do you hope to gain from your experience at in The Revolution Project?

List any problems, addictions, or behaviors you would like to change about yourself.

How do you believe you can change these things?

Describe your family situation, currently and during your childhood. (Whom you live/lived with - parents, brothers, sisters, etc.)

Describe your relationship with your father.

Describe your relationship with your mother.

What is love?

Describe God.

Describe your history with God.

Describe your relationship with God.

Describe your history with religion, church, temple, or other organized spiritual practice.

Describe your personal spiritual practice, if any.

Describe any counseling you have had in your life, and tell why.

Describe your history and current situation regarding drugs and alcohol, including prescription drugs.  List all drugs, including prescription that you currently use.

What music do you listen to?

Describe the messages in the music you listen to.

What movies do you like?

What do you like to read?

Tell what foods you eat and what you drink.

Describe your personal space. (Messy, neat, cluttered, minimalist, etc.)

How do you spend your time on Earth?

Describe your friends. (Habits, likes, how they spend time, use of substances, etc.)

Are you currently in a romantic relationship? If so please describe it.

Describe any hopes, dreams, or visions you have for your life.

List any goals you have for your life. (Any thing you would like to do, experience, or accomplish before you die.)

Do you wish to receive personal counsel for physical, emotional, or spiritual growth while at The Revolution Project? If so, which?

Tell which art forms you have experienced and list your skill level for each on a scale from 1 to 10, ten being mastery. If music, list instruments you play, and your skill level for each.

Tell which art forms you would like to experience.

Describe any experience you have working with children.

What do you feel comfortable teaching to children, youth, or adults? Please include everything you can think of, no matter how trivial it may seem.

Please select a number from 1 to 10 next to the following regarding your EXPERIENCE and mastery level. 10 being a Master.

Carpentry/Building 1 2 3 4 5 6 7 8 9 10 Teaching Children 1 2 3 4 5 6 7 8 9 10 Plumbing 1 2 3 4 5 6 7 8 9 10 Administrative/Computer Work 1 2 3 4 5 6 7 8 9 10 Electrical 1 2 3 4 5 6 7 8 9 10 Facilitating Classes/Workshops 1 2 3 4 5 6 7 8 9 10 Gardening 1 2 3 4 5 6 7 8 9 10 Physical Healing Arts 1 2 3 4 5 6 7 8 9 10 Farming 1 2 3 4 5 6 7 8 9 10 Mental/Emotional Healing Arts 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 Child Care 1 2 3 4 5 6 7 8 9 10

Please select a number from 1 to 10 next to the following regarding your DESIRE and willingness to participate.

Carpentry/Building 1 2 3 4 5 6 7 8 9 10 Teaching Children 1 2 3 4 5 6 7 8 9 10 Plumbing 1 2 3 4 5 6 7 8 9 10 Administrative/Computer Work 1 2 3 4 5 6 7 8 9 10 Electrical 1 2 3 4 5 6 7 8 9 10 Facilitating Classes/Workshops 1 2 3 4 5 6 7 8 9 10 Gardening 1 2 3 4 5 6 7 8 9 10 Physical Healing Arts 1 2 3 4 5 6 7 8 9 10 Farming 1 2 3 4 5 6 7 8 9 10 Mental/Emotional Healing Arts 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 Child Care 1 2 3 4 5 6 7 8 9 10

Why are you on planet Earth?