Gardens for Everyone Application Thanks for your interest! "*" indicates required fields NAME*(first then last)EMAIL* PHONE*ARE YOU AN ORGANIZATION/NON-PROFIT/SCHOOL?* YES NO NAME OF THE ORGANIZATION*ADDRESS* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code ADDRESS* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code COUNTY*COUNTY*WEBSITE (IF ANY)CAN WE TEXT YOU?* YES NO PREFERED METHOD OF CONTACT* EMAIL PHONE TEXT TOTAL NUMBER OF ADULTS (18+) IN HOUSEHOLD*TOTAL NUMBER OF CHILDREN (UNDER 18) IN HOUSEHOLD*APPROXIMATE NUMBER OF PEOPLE YOUR ORGANIZATION SERVES*HAVE YOU OR MEMBERS OF YOUR HOUSEHOLD PARTICIPATED IN ANY OF THE FOLLOWING PROGRAMS IN THE PAST YEAR? (CHECK ALL THAT APPLY) WIC FREE OR REDUCED LUNCH MEDICAID UNEMPLOYMENT RENT/MORTGAGE ASSISTANCE SNAP/EBT NONE DO ANY OF THE MEMBERS THAT YOU SERVE PARTICIPATE IN FOOD, HOUSING, OR HEALTHCARE ASSISTANCE PROGRAMS?* YES, MAJORITY YES, A FEW NO NOT SURE PRIMARY LANGUAGE SPOKEN AT HOME*INCOME RANGE*(select one) UNDER $15,000 $15,000 - $30,000 $30,000 - $45,000 $45,000 - $60,000 $60,000 AND OVER ON AVERAGE, PLEASE SELECT THE INCOME RANGE THAT BEST REFLECTS YOUR POPULATION'S YEARLY INCOME.*(select one) UNDER $15,000 $15,000 - $30,000 $30,000 - $45,000 $45,000 - $60,000 $60,000 AND OVER DO YOU RENT OR OWN YOUR HOME?* RENT OWN HOW LONG HAVE YOU LIVED AT THE ABOVE ADDRESS?*TELL US ABOUT YOUR ORGANIZATION*WHY WOULD YOU LIKE TO HAVE A GARDEN FOR YOUR COMMUNITY AND HOW MANY BOXES WOULD YOU NEED?*HOW LONG YOU PLAN TO STAY THERE?*IS THERE AN AVAILABLE SOURCE OF WATER?* YES NO IS THERE AT LEAST 4-6 HOURS OF SUNLIGHT AVAILABLE AT THE CHOSEN LOCATION?* YES NO HOW DID YOU HEAR ABOUT GARDENS FOR EVERYONE?*(select one) FRIEND FACEBOOK INSTAGRAM ONLINE SEARCH WORD OF MOUTH FOOD SHUTTLE WORKSHOP FOOD SHUTTLE STAFF/VOLUNTEERS OTHER Applications are accepted on a first come, first served basis year-round. If renting, submit a Landlord Permission Letter from the website or email gardensforeveryone@foodshuttle.org. Payment is due at the time of installation or site visit. By submitting this application, you agree to be responsible for the ongoing care and upkeep of the garden box. Return completed landlord permission letters to: Inter-Faith Food Shuttle Attn: Gardens For Everyone 1001 Blair Drive, Suite 120 Raleigh, NC 27603 or email to gardensforeveryone@foodshuttle.org.
