COQUILLE COMMUNITY GARDEN



COQUILLE HARVEST MOON GARDEN

Mail to: P.O. Box 165, Coquille, OR 97423

Garden located at 180 N. Baxter St.

coquillegarden@



Application for a Garden Bed

Garden plots are available on a first-come, first-served basis. If all beds are spoken for, you will be placed on a waiting list. One plot per family or household, please. Fee waivers are available for persons or families in need. Contact Garden Coordinator, Sandra Stafford, at 541-396-3508 for more information.

Please Print:

Name ________________________________________________________________________

Address ______________________________________________________________________

Home Phone ________________________________ Cell_______________________________

Email (Please Print Clearly) _______________________________________________________

Type of Bed: Regular Height (12 inches) ________ or Accessible Height (24 inches) ________

(Accessible beds are reserved for persons with physical challenges)

□ Enclosed $10.00 for Bed Rental Fee Also enclosed: SCCGA Application & Fee (See SCCGA Form)

Make Two Checks Payable to: Coquille Garden-SCCGA and South Coast Community Garden Association (Please write only SCCGA on this check)

Please send BOTH applications and individual checks – Coquille Garden and SCCGA – to the CCGA, P.O. Box 165, Coquille, OR 97423. We are looking forward to another wonderful gardening year.

Signature _____________________________________________ Date ___________________

How did you hear about the Community Garden? ___Newspaper ___Posted Flyer ____Friend

____Online ____Previous Renter ____Other? Explain _________________________________

You will be contacted as to the receipt of your rental fee and SCCGA fee, with the dates available for the garden orientation and an overview of the rules.

Attending an Orientation Session is mandatory before you begin to garden even if you have had a bed at the garden in previous years.

Office Use Only:

Garden Applications and Fees Received on: ____________

Bed # Assigned ________________________ Second Bed #, if applicable_____________________

Date Orientation Session attended __________________________

Comments:

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