VINES

VINES Community Garden Plot Application

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Application Information:

We encourage everyone to complete the below section. All personal information will be kept confidential. We use this information to track our success in serving a diverse range of people.

First Name*

Last Name (Family Name)*

Email*

Phone Number*

Street Address*

City*

State*

Zip Code*

Preferred method of communication*

Primary language spoken at home (if not English)

Ethnicity

Race (Click on field below and select all that apply)

Gender

Household Income

Household Size: Number of Adults (including yourself)*

Household Size: Number of Children*

Garden / Plot Information:

Please select from the following Community Gardens & bed options:*

	Garden List
	Abbott Street-Binghamton-All Access Bed (30 inches x 10 feet, 30 inches tall - standing or wheelchair) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Abbott Street-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Corbett Ave-Binghamton-In-Ground Plot (X x Y feet) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Corbett Ave-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Cunningham Memorial-Binghamton-Raised Bed (3' x 8') -- $30/yr (This garden is full for the year - if selected, you will be placed on a waiting list and notified if a plot becomes available.)
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Front Street-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Gregory Lane-Binghamton-All Access Bed (30 inches x 10 feet, 35 inches tall - standing or wheelchair) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Gregory Lane-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Laurel Ave-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Liberty Street-Binghamton-Elevated Bed (4x10 feet, 22 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Liberty Street-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Mather Street-Binghamton-Raised Bed (5x8 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	New Street-Binghamton-All Access Bed (30 inches x 10 feet, 30 inches tall - standing or wheelchair) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	New Street-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Oak St/ACA-Binghamton-Elevated Bed (4x10 feet, 22 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Oak St/ACA-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Park St-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr (This garden is full for the year - if selected, you will be placed on a waiting list and notified if a plot becomes available.)
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Phelps Park-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Pine St-Binghamton-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	United Presbyterian Church-Binghamton-Elevated Bed (4x10 feet, 22 inches tall) -- $30/yr (This garden is full for the year - if selected, you will be placed on a waiting list and notified if a plot becomes available.)
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.

	Garden List
	Chenango-Hillcrest-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (3 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Davis Ave-Endwell-Elevated Bed (4x10 feet, 22 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Davis Ave-Endwell-In-Ground Plot (20' x 20') -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Davis Ave-Endwell-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Deerfield-Vestal-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Mercereau Park-Endicott-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr (This garden is full for the year - if selected, you will be placed on a waiting list and notified if a plot becomes available.)
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Otsiningo-Port Dickinson-Elevated Bed (Tall Box) (4x12 feet, 30 inches tall) -- $15/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Otsiningo-Port Dickinson-In-Ground Plot (20' x 20') -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Otsiningo-Port Dickinson-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Sherman St-Johnson City-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Squires Ave-Endicott-Elevated Bed (4x10 feet, 22 inches tall) -- $30/yr (This garden is full for the year - if selected, you will be placed on a waiting list and notified if a plot becomes available.)
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.
	Squires Ave-Endicott-Raised Bed (4x10 feet, 16 inches tall) -- $30/yr (This garden is full for the year - if selected, you will be placed on a waiting list and notified if a plot becomes available.)
How many plots would you like at this site? (2 plots maximum per household)* Did you garden here last season?* Would you like the same beds as last year?* If you remember your plot number from last year, enter it below. We will cross-reference it with our records.

Questions and Comments

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