PHS | Garden Tenders Registration

Garden Tenders Training Course Registration

Exact address of lot:	(ex: 2345 N. Broad Street—do NOT use corner of Broad & Lehigh)
Name of group:
Council district:
Contact person:
Street Address:
City/State/Zip:
Phone (day):
Phone (evening):
Email:

Training Course Participants

Name:
Street Address:
City/State/Zip:
Phone:
Email:

Name:
Street Address:
City/State/Zip:
Phone:
Email:

Name:
Street Address:
City/State/Zip:
Phone:
Email:

Name:
Street Address:
City/State/Zip:
Phone:
Email:

Name:
Street Address:
City/State/Zip:
Phone:
Email:

Owner of lot:

Permission to garden:	applied for
	received

Brief description of the lot (Is it fenced, covered with weeds, already cleaned, etc.?):

Brief description of your group's gardening experience:

What community organizations is your group affiliated with?
(Example: neighborhood association, town watch, youth & school related programs, church, etc.)