Volunteer on the Land 2009-2010 Form

How Can I Help?

The Gesundheit! Institute —
Bringing Fun, Friendship and the Joy of Service Back into Health Care

Volunteer Information form — If you wish to volunteer, please print this form, fill it out, and mail it to:

I Wanna Volunteer! Applicant
Gesundheit! Institute
HC 64 Box 167
Hillsboro WV 24946

Basic Information

name, street address, city, state, zip, country

e-mail address

your phone number and the best time to contact you

Emergency contact information
Name/relation
name, street address, city, state, zip, country, e-mail address, phone number

are you over 18? (we need to know)     yes       no     your age:

food allergies  

What dates are you available to volunteer?
(please include all possible blocks of time)    
Possible volunteer dates: December 23-January 3, March 26th-31 and beginning of mach for spring break, April 9-14, May 7-12, June 1-30; July 1-31; August 1-31.

What mode of transportation would you use? we are able to pick up and drop off volunteers arriving by train (White Sulfur Springs, WV only) or airplane (Greenbrier Airport in Lewisburg, WV only). the site is also easily accessible by car.

Would you come alone? (consider pets, children, spouse, other responsibilities)   ÿ yes         ÿ no
    we have our own dogs here on the land.  Please, leave your pets at home or with trusted friends

What language(s) do you speak?

If you have ANY medical condition, please inform us

Your Story

Tell us about yourself. We want to know what you love to do, and how you are utilizing your skills, or developing new ones, to move in the direction of your dreams.

Write about your motivation for volunteering at G!I West Virginia considering what you have learned of the Gesundheit vision from Patch’s two books.

Convey the work/play activities, etc. that currently occupy your time.

Describe a personal experience of the joy of service.

Give an example of how smart you are in the way you love.

What was the pain that healed you the most?

What is your greatest fear, and what can you do to transform, dissolve or defeat it?

Please Mail (not e mail) To:

I Wanna Volunteer! Applicant
HC 64 Box 167
Hillsboro, WV 24946 USA

Gesundheit Land Staff keeps all applicant information confidential and will share it with no one.