Young City Farmers Application Form

Application to join the Young City Farmers Programme Monday 23rd August to Friday 3rd September 2010

* = must provide information

Name *:

Address *:

Email *:

Phone Number *:

Date Of Birth *:

Education & Qualifications *:

Employment/Work History *:

What interests you about food, farming and the countryside *:

What are your aims and ambitions for the future *:

Why do you want to join the Young City Farmers Programme *:

Have you had any experience of food, farming or the countryside *:

How did you hear about the Young City Farmers Programme? *:

Are you available to attend the whole of the programme from 23rd August to 3rd September 2010 *:

Is there any other information you wish to add in support of your application *:

1. Please provide the name and contact details of one person who knows you and who could confirm your suitability to participate in the programme. (This should not be a member of your family)

Reference Name *:

Reference Address *:

Reference Phone Number *:

Reference Email *:

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