Technical Assistance Request
Fill in as much information as you can or are comfortable with. Please share general information about your organization or self and the nature of your request. We'll get back to you as soon as possible. If a question does not apply to you, simply put N/A
Email address *
Name of Individual and Title *
Your answer
Name of Organization *
Your answer
Years in operation *
Your answer
Address *
Your answer
Zip code *
Your answer
Ward *
Your answer
Who owns the land you grow on? *
Your answer
How is your land currently zoned?
Your answer
If you have a business license, what type is it?
Your answer
What is your approximate annual revenue?
Your answer
Number of employees: *
Your answer
Number of apprentices: *
Your answer
Do you currently have insurance? *
Do you currently have health insurance through your grow operation? *
Do you currently have workers compensation through your grow operation?
Would you be interested in education around insurance or worker benefits?
Type of technical assistance request *
Please describe what you'd like assistance with: *
Your answer
Is there any specific aspect of urban farm business that you'd like further information on? *
Your answer
Prior to receiving assistance, would you like us to enter into a Non-Disclosure Agreement?
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This form was created inside of Advocates for Urban Agriculture.