Pasado's Safe Haven Internship Application

Personal Information:
Your Name:
E-mail address:
Address:  No P.O. boxes please
City/St/Zip
Hm Phone: Cell:
Date of Birth:  
Who can we call in case of an emergency?
Their phone number:
Medical Insurance carrier:
Do you have a valid driver's license?   YES  NO
Personal reference (non-relative only):
Name: Phone:
Education/Professional Information:
Place of employment (if applicable):
School/university:
Year: Freshman Sophomore Junior Senior Graduate School
Your major:
Educational Reference #1:
Name:   Phone:
Educational Reference #2:
Name:   Phone:
Internship Information:
You may be lifting animals, feed bags, or hay or straw of 50 lbs or perhaps more.
Do you have an physical limitations that may limit the work you may be
asked to do on the farm?YES NO If yes, please explain:
Are you allergic to any animals? YES  NO
Why do you want to intern at Pasado's Safe Haven?
Are you afraid of any animals such as birds or dogs? YES  NO
If yes, please explain: 

Interns are asked to do just about anything and everything to help us support the animals. This can mean helping in the office writing out envelopes to scooping poop. Would you have
a problem with this? YES  NO
Have you ever been a plaintiff in a lawsuit? YES  NO If yes, please explain:
Pasado internships are unpaid. Are you capable of paying for your own living expenses for a three-month period? YES NO (If living on-site, living quarters are provided at no charge to interns.)
What other information would be helpful to us in getting to know you better?
Are you a vegan? YES NO Vegetarian? YES NO
Pasado Internships require a 3-month commitment. You also live on-site at Pasado's Safe Haven. Confirm that these arrangements are
amenable to you:
YES - I can commit to a solid 3-month commitment
and would love to live on-site at Pasado's!
NO - I'm afraid I may not be able to commit.
I am applying for the following internship dates: (Choose one only):
Summer June through August
Fall September through November     
Winter Beginning Nov., Dec., Jan., or Feb.
Please note exact dates that you can serve:
From   To:


Copyright © 2009 Pasado's Safe Haven             Pasado's Safe Haven is a 501(c)( 3) non-profit organization.

 Charity Navigator, America's premier evaluator of charities, has awarded Pasado's Safe Haven its highest rating, receiving
a 4-Star Rating - for five consecutive years!