PRODUCERS LAB: A Green Career Landscaping & Construction Pathway at The Herban Farmacy
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Name:
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Emergency Contact:
*
First Name
Last Name
School:
*
Grade:
*
Age:
*
14 to 18 only
TRANSPORTATION NEEDED?
*
Please Select
YES
NO
If transportation is needed and the address is different from the address above, please enter the pick-up address.
If transportation is provided at a designated pick-up location in your neighborhood, will you be able to travel to that designated pick-up locations as well as be dropped off at that same location?:
*
Please Select
YES
NO
Why would you like to work at the Herban Farmacy?
What interests you the most?
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Gardening
Working with Animals
Cooking / Nutrition Workshops
Learning Construction
Learning Landscaping
Being in Nature
Gaining Leadership Skills
Partaking in Creative Arts
Other
The Herban Farmacy program operation and work hours are 9:30am to 1:30pm on Tuesday and Thursday, and 8am to 12pm on Saturday. Will you be committed to this multi-day work week and personal growth throughout the program?
*
YES
NO
How did you hear about us?
*
Please Select
Website
Social Media
Friend
Other
If referral, who referred?
*
Thank you for applying! We will review your application and be back in touch with you shortly!
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