Pennypack Farm & Education Center - Application for financial support in our summer 2020 CSA
Hello, and thank you for taking the time to inquire about our veggie program and financial support. We look forward to being in touch with you, but first need to gather some information. Please fill out the questionnaire below and we will get back to you soon!
Full Name *
Your answer
Email *
Your answer
Address *
Your answer
Phone number
Your answer
How many people are in your household? *
Your answer
Do you have any school-aged children or adults over the age of 60 in your household?
What is your annual household income? *
Your answer
Do you receive any SNAP benefits, other government support, or participate in a local food pantry? If so, please describe.
Your answer
Can you describe your financial hardship, and why you are asking for support in this program? *
Your answer
What would it mean to you be to be able to participate in Pennypack Farm's summer vegetable CSA? *
Your answer
The summer CSA is a weekly pickup at our Horsham farm to pick up your vegetables, either on Monday, Wednesday, or Friday between 12pm-7pm. Can you commit to this on a weekly basis? (You can also send someone on your behalf) *
Anything else you'd like us to know? Or, questions you have?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Pennypack Farm Education Center. Report Abuse