* 1. Full name:

* 2. Email:

* 3. Address:

* 4. Home Phone:

* 5. Cell Phone:

* 6. Check all that apply:

* 7. Why are you interested in the Farm Beginnings Program?

* 8. Briefly describe your prior farming experiences.

* 9. What is your first language?

* 10. How well do you read and write in this language?

* 11. How well do you speak English?

* 12. How well do you write in English?

* 13. What other languages do you speak? (if any)

* 14. In general what are the best times for us to schedule field trips, tours, and other meetings? Feel free to check all times that work for you.

  8 am - 12 pm 12 pm - 5 pm 6 pm - 9 pm
Mon - Fri

* 15. The course is offered on a sliding scale, from $0-200, with an average tuition of $100.
What amount are you able to pay?

* 16. How did you hear about Farm Beginnings/FARMroots?

Unable to pay more now? Please consider making a contribution in the future!

Hay solicitudes a disposiciĆ³n en espaƱol (http://www.surveymonkey.com/s/solicitudfarmbeginnings)
Please fill out applications by Wednesday, September 18, 2013.

For further questions about the course at Ulster County Cooperative Extension, NY, please contact Rachel Schneider, HVF Learning Center Administrator, at rachel@hawthornevalleyfarm.org, or at 518-672-7500 x 236. 327 County Route 21C, Ghent, NY 12075.

For further question about the course at GrowNYC in New York City, please contact Christopher Wayne, New Farmer Development Project Coordinator, at cwayne@greenmarket.grownyc.org. or at 212-341-2256. 51 Chambers Street, Suite 1231, New York, NY 10007.