Name*

Please upload a Selfie/Headshot so we may put a face to the name.*

Today's date*

E-mail*

Phone*

Skype*

How did you learn about us?

Birthdate*

Address*

Emergency Contact Name*

Emergency Contact Phone*

Emergency Contact Address*

Desired Arrival Date*

Desired Duration of Stay*

2 Months3 Months4-5 Months6+ Months

Please answer the following questions completely and honestly.

Commitment

At OrigenCacao, we don't follow a structured workday. Are you able to work independently, follow directions, log your progress, be punctual, work as a team, and be flexible? Please state an example.*

Have you prepared yourself to be financially responsible while you are at Origen EcoResort?*

Interns are responsible for transportation, meals, program fees due to Origen EcoResort and $100 deposit to reserve your space. This deposit will be held as a damage deposit and will be returned less any damages incurred, upon exiting.

Health

We highly recommend that you have personal health insurance.

Do you have any chronic physical conditions that could prevent you from performing farm labor work which can be long hours in the sun & rain, needing much strength & stamina?*

Do you have any history of emotional and/or mental imbalances?*

Are you currently taking any kind of medications? If so, please state the medication and what it’s a treatment of.*

Do you have a dietary preference?

VegetarianVeganPescatarianRawCarnivoreOmnivoreGluten-Free

Would you like to tell us anything regarding your dietary preference?

Getting to know you...

What kind of education have you had?*

Have you ever lived in a community before? If yes, Please describe your experience. Please include your most favorite and least favorite aspects of community living.*

What attracted you to become a part of the Origen EcoResort community?*

What are your areas of expertise? (Please elaborate)*

What Internship Track would you like to apply for?*

Chocolate MakerChefFarmerGuest Services

Describe your biggest accomplishment in life so far.*

If you could change one thing about yourself, what would it be?*

Describe your style when it comes to dealing with conflict.*

How do you rate your communications skills, and have you studied any particular type?*

What is the most interesting thing that you have learned recently?*

Please list and briefly explain the goals you have for this life. (1 yr. 5 yr. 10 yr.?)*

Please select the number of jobs you’ve held over the last 5 years from the drop down list below*

Click to Select Number of Jobs12345

Please list the jobs you’ve held for the last 5 years in the fields below*

Do you have a resume? If so, upload here.. (PDF Format only)

Please list two PERSONAL references along with email & phone numbers*

Please list two PROFESSIONAL references along with email & phone numbers*

Please use this space to ask questions or share additional information about yourself.*