GIVE Gardens Application for Urban Oasis Project

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Please fill out everything you can so we can get your info ! We do not share ANY personal information with ANY outside organization. Some anonymous data may be used in aggregate for reporting and fundraising purposes.

name

phone

address for garden

owned or rented?

Owned

Rented

Other:

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Are you applying for a free garden, or sliding scale donation?

Free please

I can donate $50

I can donate $125 to cover the materials cost

I can donate $250 to cover the materials cost for my and Give one to someone else

I want to sponsor a garden only for someone else

Other:

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# adults in household

#of children in household

How long do you plan to stay at this residence?

Approximate household income?

How often do you cook fresh vegetables?

more than once per day

every day, once

most meals

some days

once per week

Other:

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Do you know about the SNAP doubling program at some farmers markets?

Yes

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How often do you shop at farmers markets?

every week

once a month

rarely

never

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Check the 6 veggies you'd most like to grow

Beans

Beets

Cabbage

Carrots

Chives

Collards

Cucumbers

Eggplant

Kale

Lettuce

Okra

Onion

Peas

Potato

Pumpkin

Tomato

Turnip

Other:

Option 1

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Do you have a hose hookup and a hose

Yes, both

I have a hookup but no hose

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Have you grown a garden before?

Yes

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Would you be interested to meet others in your area we are also starting gardens with?

Yes

Maybe

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Submit

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