Patricia Aguilar Memorial Garden at Jacksonville Beach

Plot Application
Updated: October 5, 2012

Please read the member agreement carefully before completing this application as gardeners must adhere to the terms of the Member Agreement or risk forfeiture of their plot. Each plot is 4x12 and costs $40.00 per year to rent. Payment is due upon plot assignment, not with this application. If the rental amount is a hardship please indicate that on your application and we will do our best to accommodate your need. Send application to: Patricia Aguilar Memorial Garden at Jacksonville Beach c/o Second Harvest North Florida 1502 Jessie Street Jacksonville, Florida 32206 Or email: jaxbeachcommunitygarden@gmail.com If you have any questions, please call: 904-270-9205

NAME: (if group rental please provide the organization name and a contact person): MAILING ADDRESS:

Email Address: Telephone: Emergency contact name and phone number: Your age: (please check one) 20-30 _____ 30-40 _____ 40-50 _____ 50-60 _____ 70-80 _____ over 80 _____ Are you an experienced gardener? Yes___ No___ How did you hear about us?
For Patricia Aguilar Memorial Garden at Jacksonville Beach Use only: Date assigned: Garden Plot Number: Payment received: