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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