2021 Mentorship Application
***COVID-19 may affect program availability and logistics. We will communicate any changes as soon as possible.***

*Please note: Only registered 2021 Brown County community gardeners and New Leaf Garden Blitz customers are eligible to participate in this program through Brown County Community Gardens. The deadline for applying for a mentor is 4/15.

Thank you for applying for a garden mentor for the 2021 growing season! Having a garden mentor is a fun and rewarding way to gain the skills you need to become a successful gardener. Please read and complete the following form.

Mentors are community volunteers who self-identify as experienced gardeners. Mentors commit to meeting with their pairs five times over the gardening season (typically May through October), and we ask that mentees make the same commitment. The date and time of each meeting is flexible and is arranged between each mentor and his or her mentee.

Please also note that, due to the number of available mentors, we cannot guarantee that you will be matched with a mentor. If you receive a mentor, you will be notified in late April or early May. Priority is given to those with the least gardening experience.

This program is made available through the Brown County Community Gardens Program.
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Name *
Phone number *
Email *
Preferred method of contact
Address *
City *
Zip code *
Did you purchase a Blitz bed in 2021? *
What is your race?
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What is your ethnicity?
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What is your gender?
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Are you 18 or older?
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How many people are in your household? (Optional)
What is your gardening experience? *
Why would you like to have a garden? *
Why would you like to have a garden mentor? *
When is the best time for you to meet with a mentor? Check as many as work with your schedule.
I commit to five visits with my mentor. *
I understand that my mentor has volunteered his/her own time to meet me at five 30-minute meetings and is not expected to meet with or advise me more. *
I will do my best to meet my mentor at each scheduled appointment and will contact him/her at least 24 hours in advance if I need to reschedule. *
I understand that my mentorship may be terminated if I do not follow program guidelines and expectations. *
I grant permission to New Leaf Foods, Inc., the University of Wisconsin-Madison Division of Extension and its partners (including the City of Green Bay and Brown County) to use my photo and comments in New Leaf Foods, Inc., Extension and its partners’ (including the City of Green Bay and Brown County) reports, articles, and publications designed for educational, informational, and promotional purposes. I understand some of these materials may be posted on the World Wide Web for a period of time. *
Is there anything else we should know before we match you with a mentor (gender preference, etc.)?
In consideration of acceptance into the above referenced Brown County Program, I do hereby release, waive, and hold harmless Brown County and its officials, officers, agents and employees from liability for any harm, injury, or damage which I, or my minor children, may suffer while participating in the above described program. This includes all risks that are connected with this activity whether foreseen or unforeseen. I agree to hold Brown County and its agents, officials and employees harmless from any damage to persons or property, resulting from my negligence and/or intentional acts. I further understand that Wisconsin Statutes provide Brown County with forms of immunity from liability for injuries you may suffer from your participation in the program/event. I assert and assume the responsibility of mental and physical fitness to participate in said program, and agree to abide by all rules and requirements of the program.I am of lawful age and legally competent to sign this Agreement for and on behalf of the participant. I understand the terms and have signed this document as my own free act.I HAVE FULL INFORMED MYSELF OF THE CONTENTS OF THIS RELEASE BY READING IT BEFORE I SIGNED IT. I REALIZE THAT BY SIGNING THIS DOCUMENT I AM GIVING UP LEGAL RIGHTS WHICH I MAY BE ENTITLED TO. *
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