Back-Farms Garden Host Application | The Green Urban Lunch Box

First Name

Last Name

Email Address

Phone Number

Address

City

Zip Code

Age

Preferred Pronouns

What is your annual household income?

We ask this question because our program prioritizes participants who are on a fixed income or are low-income.

How many people live in your household?

How many people over 60 live in your household?

Do you have a physical limitation that prevents you from gardening?

Do you currently rent or own your residence?

If you rent your property, would you be able to attain permission from the property owner to install a garden?

Do you have an existing garden?

What size garden would you be willing to have in your yard?

How did you hear about us?

Additional Comments:

Waitlist Disclaimer:

I recognize that this application is to add my name to the waitlist to host a garden in the 2024 growing season.