Application Form (Sample)

Application Form (Sample)

<p> 1 APPLICATION AND AGREEMENTS FOR ENCINITAS RESIDENTS ONLY</p><p>Gardener Name(s)</p><p>Address:</p><p>City, State, Zip </p><p>Tel: (best to reach you) Email Plot Cost: One time membership startup fee: $50.00 Check Plot Choice: 10 x 10 plot annual fee $120.00 5 x 10 plot annual fee $60.00</p><p>*** Plots must be maintained all year.</p><p>Check the appropriate items: 1) I am a senior citizen ______2) I am physically disabled ____ 3) I am a veteran ______</p><p>Can you show proof that you are a resident of Encinitas? Yes___ AGREEMENTS: 1. I will start planting within a month of obtaining a plot and keep the garden maintained all year. 2. I will not plant tall crops where they will shade neighboring plots. 3. I will use organic growing methods. 4. I will pick only my own crops unless given permission by another plot user. 5. I will keep weeds at a minimum and maintain the areas immediately surrounding my plot, if any. 6. I will keep trash and litter out of the plot, as well as from adjacent pathways and fences. 7. I will participate in the Fall cleanup of the garden.</p><p>ECG Application and Agreement December 2015 2 8. I will not bring pets to the garden. 9. I agree to volunteer hours toward community gardening efforts, if I can. 10. If I must abandon my plot for any reason, I will notify the garden leadership. 11. If my plot becomes unkempt, I understand I will be given written notice to clean it up. If the plot is not cleaned up within six weeks, it will be re-assigned at the discretion of the Encinitas Community Garden Board. 12. I understand that neither the Encinitas Community Garden group nor owners of the land are responsible for my actions. I therefore agree to hold harmless either the garden group or the owners of the land for any liability, damage, loss or claim that occurs in connection with use of the garden by me or any of my guests.</p><p>DATE:</p><p>PRINT NAME:</p><p>SIGNATURE:</p><p>SIGN FORM, SCAN AND EMAIL TO: Application @encinitascommunitygarden.org</p><p>After the form is approved you will be notified of your plot assignment. Payment for your plot can be made by check or money orders. For questions and further details please email [email protected]</p><p>OFFICE USE ONLY: </p><p>REVIEWED & APPROVED:______DATE:______</p><p>PLOT ASSIGNMENT(S) ______</p><p>ECG Application and Agreement December 2015</p>

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