Highlander Research and Education Center - Workshop Work Week Application Form

1959 Highlander Way · New Market, TN 37820 · phone: (865) 933-3443 · fax: (865) 933-3424
e-mail: hrec@highlandercenter.org

Application Form
Highlander's Wild and Wonderful
Witty and Wacky
Workshop Work Week- Take 2

June 1- 5, 2010

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Note: Fields marked with an * are required. If you have any difficulties using this form, please contact our Webmaster: seedlynn at gmail.com.

Application Form

*Name(s):

Organization:

*Street Address:

*City:

State:

*Zip Code:

*Telephone:

Fax:

*E-mail Address:

Race/Ethnicity:

Age

Gender

Please tell us about your interest or area of work:

What would you hope to learn at this event?

What can you share?

What skills and experience do you have related to outside work (gardening, painting, construction, trail-building, etc.)?

Do you have any allergies (poison ivy, bee stings, etc.) that might affect your ability to work outside? If yes, please explain.

Do you have any dietary restrictions or preferences? If yes, please explain.

Scholarship Request

Some partial scholarships are available. If you would like to be considered for a scholarship, please answer the questions below.

Our scholarships are limited, so we are prioritizing low-income people who are engaged in social change. Please describe yourself in light of this - who are you working or volunteering with and what is your group working to do? If you want to send a newsletter or information from this effort to explain it, that's fine:

Please let us know how much you can afford to pay.

Send us your application.

Click the "Submit" button to send us your application. Click the "Reset" button to clear the form and start over.

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Application Form Highlander's Wild and Wonderful Witty and Wacky Workshop Work Week- Take 2 June 1- 5, 2010

Application Form
Highlander's Wild and Wonderful
Witty and Wacky
Workshop Work Week- Take 2

June 1- 5, 2010