MESA Program

Online Application - Next Level Program (NLP)

Please complete this application. When you are finished, click the "Next" button at the bottom of the form to proceed.

* indicates required field

Before submitting your host application, please take a moment to consider MESA's mission:
MESA advances a new generation of agrarian leaders, linking innovations in sustainable agriculture with ancestral knowledge worldwide to promote land stewardship, place-appropriate production and cultural awareness.

Please describe briefly how your operation's principles, community, and/or production practices may help MESA promote its mission. *

PROGRAM COSTS

Steward Compensation plus MESA Fee: *

I/we will pay the steward a wage of $/hour, plus the monthly $125 fee to MESA...
for the entire program duration
...or...
for the first # months, after which the wage may increase to
$/hour, depending on steward performance (MESA host fee remains the same).

Please describe any other compensation that the steward may expect to receive if s/he accepts your NLP host invitation -- e.g. international flight purchase, free food, etc. (If you plan to increase your host pledge beyond your $125/mo. NLP fee in order to lower your steward's NLP fee, please indicate that here as well.):

Hours: *

Expected # of advanced training hours per week (average):

Are there any months that you anticipate the expected training hours will be significantly more or less than as stated above?

If you answered yes, please describe:

Vacation: *

I/we provide paid vacation.

HOST INFORMATION

How did you hear about MESA?

Please describe who or what:

Host Farmer Name: *

(First Name)

(Middle Initial)

(Last Name)

Name of Farm/Organization:

Address(es):

Mailing Address: *
(Street Address)

(City)

(State)

(Zip)

Site of Activity Address (if different):
(Street Address)

(City)

(State)

(Zip)

Telephone:

Main:*
Cell:

Email:

Web Site:

Employer Identification Number (EIN):

Dun and Bradstreet number (DUNS):

(Most organizations, corporations, government agencies, research centers, colleges, etc. are required to register with Dun and Bradstreet to verify their business operations. Small family farms are exempt. If your family farm doesn't have a DUNS, please write "N/A" in this field.)

Position: *

Other:

Age:

Number of years in current occupation:

Number of years at current site:

Host Lives: *

Host Family:

Steward live with host family.

If so, how many family members live on site?
(feel free to describe)

Supervision:

Are you the primary supervisior? *

If not, what are the primary supervisor's name, position and email address?

(First Name)

(Middle Initial)

(Last Name)

(Position)

(Email Address)

PLACEMENT DETAILS

This placement is owned and operated by a:

Production Acreage:

Primary crops and/or agricultural income: *

Please select the choice that most accurately describes your operation: *

If Other, please describe:

Number and Type of livestock (if applicable):

My farm is: *

Check all categories that apply to your farm:
Certified Organic
Pesticide Free
Transitional
Other
Please explain if "other":

Average temperature/Typical weather:

Proximity to nearest town/city:

Please list the closest airport(s) or other transportation hubs to meet your steward: *

Timeline:

We offer (check any that apply):
Year-round training
Seasonal training, ideally bewteen and .

Please list the gender, number and nationality of MESA steward(s) that you want to host: *

Have you ever or are you presently participating in another training exchange or apprenticeship program?

If yes, please mention the program and briefly describe your experience:

Please list any agricultural associations in which you are an active member:

Please list the stewards' primary farm assignments: *

Will your steward participate in any of your sales/marketing operations? :

If yes, please describe:

Please describe the cultural activities that you will provide (e.g. family, recreational and/or community gatherings):

Please describe the educational activities that you will provide (e.g. farm workshops, visits to other farms, conferences, etc.):

Would you host a steward who speaks only: *

Spanish
French
Other
Or No, I can only accepts a steward who speaks:

If your steward needs or wants to drive, will you assist him/her to obtain a valid U.S. State driver's license?

At the height of our season, we host and/or employ:

# immediate family members
# full-time farm employees (agricultural laborers)
# part-time farm employees
# U.S. interns or apprentices
# international interns or apprentices (non-MESA)

Workers Compensation (WC): *

for our employees/staff
for hired farmworkers
for interns/apprentices

We for MESA stewards and/or other interns
-Or-
We believe we are exempt from providing WC for MESA stewards/trainees because:

LODGING AND AMENITIES

Location:

Our farm/placement location is best described as:
Very rural and remote; not within 3 miles walking or biking distance to a town
          library and grocery store, no public transportation to cities
Rural; within 3 miles walking or biking distance to a town library and grocery
          store, no public transportation to cities
Semi-rural: within 3 miles walking or biking distance to a bus stop, town library
          and grocery store, plus public transportation connections to medium or large cities
Urban: within town or city limits, easy access to public transportation

Lodging:

Type:
If Other, please describe:

Privacy:
If Shared, shared with whom? (check all that apply)
Host Family
Other interns/stewards
Farm staff
If Shared...
Bedroom is:
Bathroom is:

Lodging is best described as:
Modern & well equipped
Simple, with basic amenities (heat, indoor bathroom
Rustic, may have outdoor shower and/or toilet

Housing Site:

If off-site, distance to training site:
If off-site, travel to/from training site via:

Amenities:

Check all that apply:
Electric or gas heat
Only a wood stove for heat
Solar heat
Air Conditioning
TV
VCR/DVD
Computer & Internet for steward use
Free, daily internet on-site
Free, weekly internet on-site
Local library internet only, restricted to one hour per visit
No available internet on site or near placement
Telephone (Free local calls only; must buy own calling card for non-local calls)
Occasional, local use of insured vehicle on days off, with host permission
          (Only for stewards with valid home country drivers' licenses
          or Int'l Drivers Permits)
Easy access to public transportation on days off
Bicycle for excursions to nearby shops/town/public transit (less than 3 miles one-way)
Food provided by host to cook your own meals
          Meals shared with:
Full or partial food allowance added to monthly MESA stipend to
          buy/prepare own meals
Free, seasonal farm products. Example:

Holidays:

I/we provide the following holidays off* (choose 3 or more that will occur during your anticipated hosting period):
Memorial Day
U.S. Independence Day (4th of July)
New Year's day
Labor day
Christmas
Other:

*Because MESA is a training and cultural exchange program, MESA stewards are expected to receive a full day off to participate in at least 3 major U.S. (or home country;-) holidays with their host families or friends.

STEWARD EXPECTATIONS

Our farm/facility strongly prefers that the steward:

has % or above conversational English skills

has hands-on production experience with our primary crops

Other:

Driving: *

I/we require the steward to arrive with (check any that apply):*
a valid home country Drivers' License
an International Drivers Permit

*Note: CTP hosts please note that driving requirement will reduce the number of eligible CTP candidates.

Please list any items/clothes/gear your steward should bring with him/her:

Please list anything else the steward should know about your operation or that you want to know about the steward before his/her arrival:

REFERENCES (1st time hosts only)

Please provide the name, position (job title and if current or former) and telephone numbers of two business associates, employees, apprentices and/or interns whom MESA can contact for referral:

Reference #1:

Name:
Relationship:
Telephone:

Reference #2:

Name:
Relationship:
Telephone:

PAST MESA STEWARDS (continuing hosts only)

Past participation in MESA programs:

Our farm/facility hosted MESA stewards in the past.

If you answered "has", please provide information about past stewards below.

Previous MESA steward #1:

Name:
Country:
Program Year:
Email Address:

Previous MESA steward #2:

Name:
Country:
Program Year:
Email Address:

Previous MESA steward #3:

Name:
Country:
Program Year:
Email Address:

Completing a host application does not bind you or MESA to a participation agreement. However, MESA will consider your application valid for up to six months and notify you at least one month in advance of a prospective farmer steward's arrival.