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* 1. Authorized Resident Information

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* 3. Address

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* 5. Phone

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* 6. Are you requesting an ADA accessible plot?

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* 7. If an ADA plot is not available, would you accept a standard plot?

Qualified residents interested in leasing a community garden are required to complete this application to be considered for a garden plot. All applicants will be added to the waitlist in the order of their submission. This document represents the applicants' interest in leasing a garden plot and will not be considered a commitment until a lease agreement is executed.

I CERTIFY THAT THE INFORMATION ON THIS APPLICATION IS CORRECT, THAT I AM A CURRENT AUTHORIZED RESIDENT OF LEISURE WORLD SEAL BEACH AND I UNDERSTAND THE INFORMATION PROVIDED ABOVE. I UNDERSTAND ONLY ONE PLOT CAN BE ALLOTTED PER HOUSEHOLD BUT MAY BE SHARED WITH AN AUTHORIZED CO-OCCUPANT.

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