Master Gardener Donation Request Form (Page 3 of 4) in pdf

Master Gardener Donation Request Form Page 3

EXPERT EYE VISIT APPLICATION

NAME______________________________________________________

(Office will assign

ADDRESS___________________________________________________

CLIENT # _________)

___________________________________________________

DEVELOPMENT (if applicable)______________________________________________

PHONE Day___________________ Evening _____________________

EMAIL _____________________________________________________

DO YOU WANT A WRITTEN REPORT? ___Yes ___No

ADD ME TO MG MAILING LIST ___Yes ____No

HOW DID YOU LEARN ABOUT THE EXPERT EYE PROGRAM?

___Library ___Garden Center ___Direct Mail ___Newspaper ___Master Gardener Booth

___Friend/Neighbor ___Other

VISIT TIME AVAILABILITY • VISIT MAY LAST UP TO TWO HOURS (Check all that apply)

___Weekdays ___Saturdays ___Mornings ___Afternoons ___Evenings

ARE YOU ___a novice gardener ___a moderately experienced gardener ___an experienced gardener

PROPERTY TYPE

PROPERTY SIZE

___ Urban

___Suburban

___ Rural

___< than ¼ acre

___¼ to 1 acre ___> 1 acre

DOES YOUR DEVELOPMENT HAVE LANDSCAPE DEED RESTRICTIONS? ___Yes ___No ___N/A

HOW LONG HAVE YOU LIVED IN YOUR HOME?

___< 1year ___1 to 3 years

___4 to 7 years

__> 7 years

AGE OF HOME ___ <1 year ___ 1 to 5 years ___6 to 10 years

___ >10 years

AGE OF EXISTING LANDSCAPE (If mixed, check all that apply)

___New

___1 to 5 years

___6 to 10 years

___>10 years ___Don’t know

CURB APPEAL (foundation and landscape planting in scale and provide attractive appearance of the house)

___Satisfactory ___Needs improvement

University of Delaware • New Castle County Cooperative Extension

461 Wyoming Road, Room 131 • Newark DE 19716-1303 • 302-831-COOP (2667)

Fax (302) 831-8934 • Garden Line 302-831-8862 •

Master Gardener Donation Request Form Page 3