| First & Last Name * | |
| Preferred or Spiritual Name | |
| Email Address * | |
| Phone Numbers (Cell/Home) |
|
| Street Address | |
| City, State, Postal Code * | |
| Country * | |
| Country issuing passport * | |
| Are you 18 yrs or older? * | |
| Gender * | |
Date you are available for full-time relocation?
* | |
What is your experience with living in a
community? (please explain) * |
|
| Date of Birth (mm/dd/yy) * | |
| Marital Status * | |
| Ages of any children? | |
| How did you hear about Timeline 2012? * |
|
Why do you want to join the Timeline 2012
Community? (please explain) * |
|
What is your spiritual background? (please
explain) * |
|
How do you define spirituality? (please explain)
* |
|
How do you typically dealing with challenging
situations? (please explain) * |
|
Do you consider yourself emotionally balanced?
Why? (please explain) * |
|
| What are your strengths? (please explain) * |
|
| What are your weaknesses? (please explain) * |
|
What are your feelings on letting go of worldly
possessions? (please explain) * |
|
Are you willing to live without the use of
electronic devices? (If no, please explain) * |
|
What skills can you offer the community? (please
explain) * |
|
How would you like to contribute to the
community? (Review committee list for community
needs) * |
|
| What is your health status? * | |
Describe any health issues, medications, or
physical limitations. (please explain) * |
|
What is your typical daily diet? (please be
specific) * |
|
What is your current financial situation?
(please explain) * |
|
Do you still own any physical assets? (please
describe) * |
|
What financial contribution are you willing to
commit to support our co-creative community?
(please describe) * |
|
Personal Reference #1: (Full name, location,
email, phone, type of relationship) |
|
| Personal Reference #2 |
|
| Personal Reference #3 |
|
| Personal Reference #4 |
|
Have you ever been convicted of a criminal
offense? (If yes, please explain) * |
|
I consent to this application form being used
for the interview process. (Please initial) * | |
All the information on this application is true
and complete. I understand that if I give any
false information, omit, or misrepresent any
information that is asked, my application may be
rejected. (Please initial) * | |
If any false information, omission, or
misrepresentation is discovered after my
application has been accepted, I understand that
my acceptance may be revoked or my member status
may be terminated. (Please initial) * | |
I acknowledge that if I am accepted as a
Timeline 2012 community member, my service with
Timeline 2012 is “at will”, which means it may
be terminated by me or the Timeline 2012 at any
time. (Please initial) * | |
This application is not an agreement or
contract. I understand that submission of this
application is not an assurance that Timeline
2012 will accept me as a member. (Please
initial) * | |
I authorize Timeline 2012 to inquire into my
background, previous work experience, and
education and to contact my references and
previous employers to confirm information
supplied by me. (Please initial) * | |
I acknowledge that I have read and fully
understand this application including the above
statements and authorization for a background
inquiry. (Please initial) * | |
I acknowledge that Timeline 2012 reserves the
right to select individuals based on their
background, as well as other skills and
qualifications. (Please initial) * | |
I have read, understood and agree with the
statements above: (Please enter full name and
date) * | |
| Upload resume * | |
| Upload passport style photo * | |
|
| | |
|
