2021 Pollinator Garden Application

2021 Pollinator Garden Application

Please complete and submit this form by March 12, 2021. Contact Karen Jones (kjones@growmark.com or 309-557-6184) with any questions.
Club/Chapter/Organization Name *
County *
State *

Illinois Iowa Missouri Wisconsin
Adult Leader/Advisor Contact *

First Name Last Name
Leader's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Leader's Phone Number *

Area Code Phone Number
Leader's E-mail *
How many members are in your group? *
Where will you plant your pollinator garden? (ex: park, school, etc...) *
How do you plan to maintain your garden? *

0/500
I agree to submit written updates and photographs of the garden to GROWMARK as requested. *

Yes, I'll send updates.
GROWMARK and its affiliated companies may use information about my club and any materials I submit for publicity purposes through all their regular channels, including print, electronic, and social media. *

Yes, you may use my information.
Should be Empty: