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Growin' Good In The Hood Application
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Email
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Your email
Name
Your answer
Are you applying for yourself or your child?
Myself
My child
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Phone Number
Your answer
Age range?
(16-26)
(27-35)
(35-55)
(56+)
(10-15)
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If applying for a minor, are you willing to sign a liability waiver?
Yes
No
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Zip Code
Your answer
Do you have previous farming experience?
Yes
No
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Why are you interested in the Growin' Good In The Hood Program?(250-350 words)
Your answer
What impact do you hope to have on community by being apart of Growin' Good In The Hood?(250-350 words)
Your answer
What are some of your strengths as a person?
Your answer
Do you have children
Yes
No
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If so, how many? Are you interested in them learning to grow?
Your answer
How many days a week are you able to dedicate to Growin’ Good in the Hood?
Your answer
What does self reliance and self sustainability look like to you?
Your answer
What days of the week work best for you? Please include the time as well.
Your answer
Are you familiar with food deserts?
Yes, thoroughly.
Yes, somewhat.
No, enlighten me!
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Do you have allergies?
Your answer
What kind of food would you like to grow?
Your answer
Are you interested in growing food for profit, family, or both?
Your answer
How would you define health?
Your answer
What role do you think you play in your community?
Your answer
Send me a copy of my responses.
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