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NEW DAWN APPLICATION FORM

1. please fill in all the blanks AND THEN PRINT this page

2. sign the Applicant's Agreement
3. (if applicable) sign the Work Exchange Agreement

4. include a recent photo
5. include your reservation fee of US$50 payable to Ed Bernhardt
    (upon your arrival, your reservation fee is applied to your tuition)

6. Send all the above BY CERTIFIED MAIL to:
    Ed Bernhardt
    A.P. 372-8000
    San Isidro del General
    Costa Rica


    Your Name:
    E-mail Address:
    Mailing Address:
    City, State, Zip:
    Phone:     Fax:

      Age:     Height:     Weight:
    YES NO   Do you have any physical or mental disabilities?
    YES NO   Do you have any special needs or requirements?
    YES NO   Will you be taking medications while at New Dawn?
    YES NO   Do you get along well with others in group situations?


    Please check the course(s) you want to take:
    Tropical Medicinal Plants   Ecological Gardens / Tropical Agriculture   Spanish

    YES NO   Will you be taking these courses for college credit?
    Month/Year You Plan to Attend:

    If you plan to attend classes to improve your health, please describe your condition:







APPLICANTS AGREEMENT WITH NEW DAWN

I understand that due to limited facilities at New Dawn, persons with contagious diseases can not participate, and I hereby state that I do not have a serious contagious disease that would endanger other participants or the staff at New Dawn.  I have also filled out the application without false or misleading information.  Secondly, I agree that I have a basic human right to practice whatever health therapy I choose to improve my health under my own responsibility while studying and living at New Dawn and therefore, release all staff members at this center from responsibility and liabilities for me during my time spent at New Dawn.

(REQUIRED FOR ALL APPLICANTS)

Signed: _______________________________ Dated: _______________




WORK EXCHANGE AGREEMENT

Since our center is presently in a stage of development, we offer a work exchange program for our students to help them to lower their living expenses while enabling us to improve our facilities at the same time. Students can work in the mornings from Monday to Friday in exchange for room and board at New Dawn. Activities include gardening, harvesting, food preparation, carpentry and painting to improve the student center, cleaning and maintenance and tending animals on the farm. Here at New Dawn, our success depends upon harmonious group activities that provide us with an abundance of healthy food for everyone. To qualify, participants should simply be able to comply as follows: Enjoy work for work sake. Enjoy working with people of all ages. Be willing to accept assignments from the staff and follow them through in a responsible way.

I would like to participate in the work exchange program when I come to New Dawn.  Therefore, I'll agree to exchange my morning hours from 8 to 12 noon working on activities at the center.  If I later decide that I can't comply with this agreement, I will pay for my room and board at $10 per day.  I also agree to release all staff members at this center from responsibility and liability for me during my time spent working at the New Dawn Center.

(ONLY IF APPLICABLE)

Signed: _______________________________ Dated: _______________

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