Garden Build Program Application
Thank you for your interest in our Garden Build Program! The purpose of this form is to gather basic information about your garden needs and to determine if you qualify for our program. Your information will be kept confidential and will only be shared within our network.
Full Name *
Your answer
Email address *
Your answer
Address *
Your answer
City *
Your answer
Phone Number *
Your answer
Neighborhood *
Your answer
Zip Code *
Your answer
Primary Languge *
Do you have an outdoor space at your home that receives at least 6 hours of sunlight per day and can you accommodate a 4 x 8 garden bed? *
Do you own your own home? *
If not, do you have written permission to garden? *
How much gardening experience do you have? *
How many people live in your household? *
Your answer
Approximately how much do you spend on groceries each week? *
Your answer
How many times per week do you eat/prepare fresh fruits and/or veggies? *
Your answer
Are you committed to growing vegetables, herbs, and fruit in your garden bed this year? *
Are you prepared to commit to regularly work to maintain your garden? *
Are you physically able to participate in the installation of the garden? *
Are you committed to recruiting 3 to 5 people to assist in your garden installation? *
Which days and times are you available for your installation? *
After your garden installation, you will receive support visits to assist with gardening needs, supply materials (if needed), answer questions and provide assistance. Are you committed to scheduling the follow-up support check-ins? *
Will you complete a survey summarizing your experience to assist us in strengthening our program for future participants? *
Please tell us why you wish to receive a garden from us *
Your answer
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