Application for Building a Better World

ABOUT YOU

Email

Please type it carefully to be sure it's correct or we won't be able to reach you.

Age

Pronouns

If you'd like to specify your preferred pronouns, you're welcome to do so here.

Nationality

Passport info (for those who are not US citizens)

If you are NOT a citizen of the US, please enter your passport number, country, date of expiry, and place of issue.

Have you been to Earthville Institute (or Dharmalaya Institute) before? If so, when and for what purpose?

Tell us something about you. Who are you and what do you care about?

What are your main interests, passions, and values? Who do you aspire to be? What do you aspire to do with your life?

ABOUT YOUR INTEREST IN THE PROGRAM

Why are you interested to join the Building a Better World program?

Please give a thoughtful and detailed response here. What attracts you to this program? What kind of experience are you hoping to have? What is it that you hope to learn and take away from it?

Have you done any other programs similar to this? If so, what and where?

Comments about desired mode(s) of participation in BBW

Feel free to elaborate here.

Proposed start date

When might you like to begin participating in BBW? If there's a particular workshop/event you might like to join as your entry point into the program, please mention the event name and start date here.

Proposed duration of participation

How long might you wish to participate in the BBW program? If you aren't sure, please say so and then provide your best guess.

More about your topical interests:

Feel free to elaborate here.

More about the work you're interested in doing:

Feel free to elaborate here.

Any concerns or physical limitations with regard to physical work?

Additional comments

Anything else you'd like to tell us?

GENERAL INFO

Food allergies and/or dietary preferences

We serve only healthy, mostly-organic, plant-based (vegan vegetarian) cuisine. We also do our best to accommodate special needs within our limited capacity, so if you are diabetic or have food allergies, gluten intolerance, etc., please let us know so we can do our best to take care of you.

Emergency contact

Provide the best person to contact in case of emergency. Please enter the name, phone number, email address, and relationship (e.g. mother, husband, friend). If you'd prefer to give us this info when you arrive, that's OK too, but we prefer to have it just in case.

Do you have any injuries, medical conditions, or other health concerns?

Any medical information will remain confidential. Please do inform us fully as it is our responsibility to be aware in case of emergencies. Do you have any allergies or sensitivities? Any physical limitations such as difficulty sitting or walking, back pain, etc.? Any emotional or psychological challenges? If yes to any of the above, please give details.

Medications

This information will remain confidential. Please do inform us fully as it is our responsibility to be aware in case of emergencies. Are you currently taking any medications? If so, which medications and for what conditions?

Name(s) of person(s) who told you about Earthville Institute

If someone told you about Earthville Institute, what is that person's name?

Just one more step:

After you click the "submit" button below, your application will be sent to us for review. Follow-up questions and/or an online interview are often part of the application process. After we have reviewed your application (normally within 1-2 weeks), we will send you an email that will notify you of your application status (e.g. pending interview, pending receipt of deposit payment, waiting list, etc.).

APPLICATION FOR
BUILDING A BETTER WORLD

Please read all the information on the program description page closely before completing the form below.

To help us evaluate your application, please answer all the required questions thoughtfully.

APPLICATION FORBUILDING A BETTER WORLD

Please read all the information on the program description page closely before completing the form below.

To help us evaluate your application, please answer all the required questions thoughtfully.

APPLICATION FOR
BUILDING A BETTER WORLD