Sample Nutrition GardenVolunteer Interest Form

Application due:

____I wish to become a Nutrition Garden Volunteer and would like to be accepted into the Nutrition Garden Volunteer program offered by University of Missouri Extension. I understand that if accepted into the program and that in exchange for the training, I will agree to provide at least 30 hours of volunteer service to the Nutrition Garden Volunteer program during the coming year.

Signed ______Date of Application______

Name (print)______

Address ______

City______State_____ Zip______County______

Telephone (day) ______(evening) ______

Email ______T-shirt size ______

1.Please list any training or experience in gardening or food related areas. ______

2. List of activities or hobbies related to gardening and food? ______

______

3.List experiences in working with the community, schools, churches, youth, senior citizens, etc:

______

4.How did you learn about the Nutrition Garden Volunteer program? ______

5.Most of the volunteer time for this project will be during the school day or during afterschool programs. If you are selected as a Nutrition Garden Volunteer trainee, would you be availableto volunteer during these hours? ______

6.Please describe any previous volunteer or teaching experiences.

______

  1. Please list any special skills (computer, art, writing, photography, carpentry, tilling, construction, etc.) which may be useful to the Nutrition Garden Volunteer program development. ______
  1. What kinds of volunteer projects would be the most comfortable for you to do (teaching, garden construction, garden maintenance, or other)? ______
  1. Why do you want to become a Nutrition Garden Volunteer?

______

______

______

The Nutrition Garden Volunteer Training is a six-week training program, held once a week every ______from 8:30 a.m. to 2 p.m. The dates and locations are the following:

Applications are due:

Questions? Call

Return application by ______to:University of Missouri Extension

Attn: Eating from the Garden

Project funded by Health Care Foundation of Greater Kansas City

Equal opportunity is and shall be provided to all participants in Extension programs and activities, and for all employees and applicants for employment on the basis of their demonstrated ability and competence without discrimination on the basis of their race, color, religion, sex, sexual orientation, national origin, age, disability, or status as a Vietnam-era veteran. This policy shall not be interpreted in such a manner as to violate the legal rights of religious organizations or military organizations associated with the armed forces of the United States of America.