Contact Information Date of Birth * Email Address * Phone Number * Permanent Phone Number Permanent Address (if different from current address) Place of Birth * Country of Citizenship * Type of Visa * In Case of Emergency
Who shall we contact in case of emergency?
Relationship to you * Home Phone Number * Work Phone Number Educational Background Name of High School * Location of High School * Date of Graduation * List any college or university attended starting with earliest enrollment:
Institution Name Date of Completion Credits Earned Institution Name Date of Completion Credits Earned Institution Name Date of Completion Credits Earned Employment History List your employment. Please be specific. Attach resume below if necessary. Professional Reference Current Position * Employer Name * Work Phone Number * Email Address * Biodynamics and You How did you learn about The Pfeiffer Center? Please be specific. * Are you acquainted with biodynamic agriculture and/or the works of Rudolf Steiner? If so, please list what you have read. * Please list your personal Interests - skills, hobbies, musical instruments, languages, etc. * Why do you wish to be an intern at The Pfeiffer Center? What are your personal and professional goals in relation to this position? * In approximately one page, give a brief biographical sketch of yourself, including any information which you think may be helpful to us in considering your application. * Attach Supplemental Documents You may attach a PDF version of your resume, letter of reference, and/or medical form here, if you have them available when you submit this application. If you do not have them at this time, please send them to us at your earliest convenience:
Mail to Pfeiffer Center Admissions - 260 Hungry Hollow Road, Chestnut Ridge, NY 10977 or email to email@example.com File Upload File Upload File Upload I certify that all the responses on this application are complete and accurate to the best of my knowledge. I understand that falsifying any part of this application may result in cancellation of admission and/or registration. * Please click "submit application" below. Once your application has been submitted you will be redirected to a page that allows you to pay the $10 application fee. If you have uploaded any documents to your application, it will take time to submit your form and be redirected. Please click "Submit Application" only once. Thank you!