Adopt A Garden Bed Form

First Name

Last Name

Phone

Age?

Under 18
18-25
26-34
35-54
55-64
65 or over

Gender

What is your race/ethnicity?

Are there youth (<24 years old) living in your household?

Why are you interested in participating in a community garden?

Access to fresh vegetables
Community involvement/socializing
Recreation
Learn more about gardening
Save money
Enjoy gardening
Other

What kind of space are you interested in?

An individual garden spot just for me and my family
A shared plot where many people work together and share the harvest
A food pantry plot where people work together and donate the harvest to those in need

How many plots would you like to take care of?

1-2 plots
3-4 plots
5-6 plots
6+ plots

If you participate in a community garden, what types of plants are you interested in growing?

Fruits
Vegetables
Herbs
Flowers
Native Plants
Other

How much time would you be willing to spend volunteering in a community garden?

Less than 2 hours a week
2-4 hours a week
5-7 hours a week
8-10 hours a week
More than 10 hours a week

Which days/times would you be available to garden?

Would you participate in mandatory training or community sessions?

Yes
No
Unsure

How much gardening experience do you have?

0-1 years
2-5 years
6+ years

Do you currently live in Jefferson or Washington Housing?

I am human:

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Adopt A Garden Bed Form