Resident Application

Download one of the files below. Print it, fill it out, place it in an envelope and mail it to:

Executive Director            or Fax to:      937-498-4441   
Clear Creek Farm              or Email to:  chad.gessler@clearcreekfarm.org or  clear_creek_farm@embarqmail.com
P.O. Box 1433
Piqua, OH 45356

If you have Microsoft Word on your computer, click here to download the Application Form in Word format.  Application also includes a checklist of documents needed on day of placement.  This checklist will be the last page of the application file.

If you do not have Microsoft Word on your computer, click here for a PDF file of the Application Form. The PDF file requires an Adobe Acrobat Reader.  Application also includes a checklist of documents needed on day of placement.  This checklist will be the last page of the application file. If you do not have this reader, click here  to download the free reader from Adobe.