Community Outreach Reimbursement

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Please fill out the form entirely. Reimbursements are intended for community gardening, farming, and land stewarding education. Award amounts are determined by the level of community outreach and do not exceed $200 per event/per day.

Email *

Date of event/workshop/training session. (Please submit a form for each occurrence; only one activity considered per event date.)

YYYY

Education/Event Site (full address)

Name of Organization

Budget Category

Organic Food Growing Experiential Workshop

Community Garden Initiative/Training

Q & A Farm Tour

K-12 Student Agriculture Education

Description of Education Activity

Hours (Length of activity)

Number of registered participants.

Submitted By (First and Last Name) *

Phone

Send Check to (full name)

Street Address

City/State/Zip
*

Send me a copy of my responses.

Submit

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