Application

Your Name *

First Name

Last Name

Ideally, how many days per week would you want your child to participate?

4 days per week

3 days per week

2 days per week

1 day per week

What days of the week would be most convenient to have your child participate in the program? (check all that apply)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What would be a convenient start time on days the program is offered? (check all that apply)

4 pm

4:30 pm

5 pm

What would be a convenient end time on days the program is offered? (check all that apply)

5:30 pm

6 pm

6:30 pm

Does your family compost (i.e. return food scraps to the soil instead of putting them in the trash)?

Yes

No

Do you maintain a home garden or edible houseplants (e.g. potted herbs)?

Yes

No