Gleaning Request Form
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
What Type of Fruit Needs to be Picked?
Pick Date of Anticipated Ripeness...
-
Month
-
Day
Year
Date
Select Quality of Fruit. "1"= small, insect damage or difficult to pick to "5" Higher quality suitable for Donation, accessible on well maintained trees...
1
2
3
4
5
Questions, Comments and/or Additional Information
Please include a photo of your tree(s). If applicable, a photo of seeds is helpful to determine ripeness
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What is your Association to this Property?
Owner
Occupant
Renter
Realtor - Vacant Property
I Release The Greenhouse Project from any Liability Associated with Fruit Gleaning
I Release The Greenhouse Project
Thank You for your Participation!
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