Camphill School and Camphill Farm Community Hemel en Aarde Valley, Hermanus
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2.Address |
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| 3. Telephone/Fax | ............................................................................................................................... | ||||||
| 3.1. E-Mail | ............................................................................................................................... | ||||||
4. Date of birth |
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5. Nationality |
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a.)South African applicant: I.D. Number |
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b.)Foreign applicant: Passport number |
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6. Home language |
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7. Name, address and telephone number of a relative or close friend (state relationship)
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8. Marital status |
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9. Children (state number of children and their ages) |
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| 10. Other dependents (please list) | ............................................................................................................................... | ||||||
11. Do you have any financial obligations? |
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12. Do you have medical insurance? (please give details) |
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GENERAL INFORMATION |
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13. I would like to join from (earliest date) |
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14. For a minimum period of (Please note that we can only accept co-workers who commit for at least one year.) |
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15. What is your motivation? (e.g. I need work, I want to be trained as a care-worker, I have a special interest in ............, I wish to do alternative civil service or voluntary social year, etc.) |
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| 16. Would you like to work with children or with adults? | ............................................................................................................................... | ||||||
| 17.(For farm co-workers only): To which workshops do you think you could contribute? |
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18. Have you ever visited a Camphill community? |
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19. If Yes: Which one and for how long? |
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20. Do you have a driver's licence? |
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21. Do you play a musical instrument or have other artistic skills? |
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22. What are your plans after you leave Camphill? |
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| GENERAL HEALTH | |||||||
23. Do you have any special dietary requirements (e.g. vegetarian)? |
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24. Do you suffer from allergies? |
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25. Do you suffer from chronic illness or physical disabilities? |
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26. Do you have psychological problems/breakdowns? Dependencies in the past or present? |
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27. Have you taken prohibited drugs? |
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28. If Yes, did you stop, and when? |
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Camphill School and Camphill Farm Community
Hemel en Aarde Valley ACCEPTANCE FORM
I , .........................................................................., hereby confirm that I have read, understood and agree to all conditions as stated in the general information sheet.
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