Harvest Academy Enrollment Request

Harvest Academy Enrollment Request

Thank you for your interest in Harvest Academy! Complete this short form to tell us a little about your family, garden, and scheduling preferences. We'll review your information and reach out to discuss your garden and finalize the best program for your family.
Parent Information
Parent/Guardian Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Student Information
Number of Children Participating
Child #1 Age
Child #2 Age
Child #3 Age
Child #4 Age
Garden Information
Service Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Tell us about your garden
Describe your existing garden set up. Number and size of beds, operational status, history of success and challenges.
Program Selection

We'll do our best to accommodate your preferred day and time based on route availability. Final schedules will be confirmed after enrollment.
Preferred Day(s)
Preferred Time Window
Choose your season:
Scholarship Information
Payment options
Additional Information
Allergies, medical concerns, or accommodations (for all participating children)
What are you hoping your family gets out of Harvest Academy?
Anything else you'd like us to know?
How did you hear about Harvest Academy

Other
Should be Empty: