Work Exchange Application


Please complete and mail to:

Patrick Moser & Elizabeth Elliott

845 Peahi Road

Haiku, HI 96708







Birth date:


Phone #:


Cell phone:

Person to contact in case of an emergency:


Phone #:

E-mail address:

Health Insurance:



Health Insurance Provider:



Are you familiar with living in the tropics?       bugs?          weather?


Do you have any food allergies?

Do you plan to rent/buy a car while here?

Arrival date:

Departure date:

(Dates may not be changed once they have been settled upon.)

How did you hear about PatÕs farm?




Your experience:

Please take time to look at the website so that you are familiar with Biodynamics as a farming philosophy.

Do you have any questions about Biodynamics?





Do you have any farm experience? Or gardening on a large scale?



What do you hope to learn while here at the farm?




Anything else youÕd like to tell us about yourself?





Any questions, please contact Pat or Elizabeth at: Both Patrick and Elizabeth like to answer questions.


Sharing our life and our life-style is a good thing. We try to make it a good experience for both of us. The more you can tell us about yourself and your ideas about who you are and what you are trying to get from this experience helps us to figure out if we are a good match.


Please send a photo of yourself.