Print out and fill in form, and mail with any additional documentation to:

Maysie's Farm Conservation Center
15 St. Andrew's Lane, Glenmoore, PA 19343

Maysie’s Farm Conservation Center
Sustainable Agriculture Internship Program
Intern Application



Date of Birth (optional):

Social Security Number (optional):


Country of Citizenship:

Do you have a driver's license?

Do you have a vehicle?


Would you need housing?

Dates of availability:



Educational Background (list schools attended, degrees earned and dates):




Work Experience (for recent positions, list job title, duties, location, and dates):




Relevant Experience (list agricultural, educational or conservation related experiences or interests):



Please include a brief essay regarding how this internship experience fits into your professional, educational, or philosophical plans for the future (attach additional sheets if necessary):


Other Special Skills (such as in languages, construction, mechanics):


References (from school, work, housing, or other):



Please include your resume and any existing letters of reference.


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Signature                                                 Date