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The Green Urban Lunch Box
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Farm Apprentice Application
Order Number
First Name
*
Last Name
*
Email Address
*
Phone Number
*
Address
*
City
*
State
*
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West Virginia
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Zip Code
*
How did you hear about us?
*
Social Media
Event
Google Search
From a Friend/Word of Mouth
Other
Age
*
Preferred Pronouns
*
Male (He/His)
Female (She/Hers)
Other (They/Them)
Prefer not to discuss
What is your annual household income
*
We ask this for our records and reports only. You personalized info will not be shared outside of our organization and your answer will not affect your application.
How many people like in your household?
*
Why are you interested in participating in this program?
*
Do you have any experience with gardening or farming?
*
Yes
No
If yes, at what capacity?
*
What do you hope to learn from this program?
*
What is your experience working outside doing physical work?
*
Do you hope to start your own farm business once completing this program?
*
Do you have issues with working in all weather conditions?
*
Yes
No
Do you have reliable transportation to our farm at 3188 S 1100 W?
*
Yes
No
Do you have time to engage fully in this program (7-8 hours per week)?
*
Yes
No
What days and hours are you available to complete the 5 hours of hands on learning in the Farm Stewardship?
*
Which option do you want to participate in:
Full Course
Spring Module
Summer Module
Fall Module
Online Only
Additional Comments
Information Summary