Membership Questionnaire


  • Your name:

  • Date of birth:

  • Email:

  • Dates you would like to visit: From to

  • Check here if you have any children that would be joining you at OM.

  • If so, please tell us about them:

  • Check here if you have any pets you would like to bring with you to OM, and tell us about them.


  • Check here if you have any physical limitations or ailments which would prevent you from doing certain kinds of work.

  • Check here if you are willing to camp if an indoor space is not available.

  • What dietary restrictions do you practice?
    Omnivore
    Vegetarian
    Vegan
    Other:

  • Check here if you are on any medications.

  • Check here if you smoke tobacco.

  • What skills and interests are you bringing to our community?
    Cooking
    Dairy
    Construction
    Forestry
    Medical
    Consensus Groups
    Poultry
    Goats
    Herbs
    Sales/Marketing
    Other:

  • Are you a self starter, or do you prefer to be given tasks to complete?

  • How did you become interested in community, and what brings you to OM specifically?

  • Check here if you have any debts. If you do have debts, how, if ever, do you plan to pay them?

  • Check here if you have any current legal issues.

  • Please list emergency contact information, phone number of relative or friend, in case of an emergency during your visit.

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