MASTER GARDENER VOLUNTEER PROGRAM APPLICATION FORM

 Applications must be received not later than Monday, July 31, 2006

 A.  DEMOGRAPHIC                              PLEASE PRINT                           Date: ____________

Name: _______________________________________________________________________

Mailing address: __________________________________________________________________

City: ____________________________ State _____ County _______________ Zip ___ _____  

Telephones:  Home: ________________ Work: ________________ Cell: _____________________

            (Please include the Area Code if any of your numbers are not within the “850” calling range).

E-mail address: ____________________________________________________________________

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B.  GARDENING   (If additional space is needed, please use other side of this page)

 1.  Why do you want to become a Master Gardener? _________________________________

 2.  What are your particular areas of gardening interests? _______________________________

 3.  Yes_____ No _____ Are you physically able to do gardening work?  If no, what limitations do you

have? _______________________________________________________________________

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C.  NON-GARDENING   (If additional space is needed, please use other side of this page)

 1.  Yes_____ No _____ Are you presently employed?  If yes:

            Who is your employer? _____________________________________________________

            What do you do? _________________________________________________________

            What is your normal work schedule?   __________________________________________

 2.  Yes_____ No _____ If you are not presently employed, are you actively looking for a job?

 3.  Yes_____ No _____ Are you retired?  If yes:

            Who was your last employer? ______________________________________________

            What type of work did you do? _________________________________ ___________

            What was your major field of employment (or profession)__________________________

 4.  List any special talents you have which could enhance your Master Gardener volunteer activities (such as administrative, speaking another language, teaching, writing, etc.)________________________

 5.  Yes_____ No _____ Do you have basic computer skills?

 D.  During the Master Gardener Basic Training Class period (Part One) from September 7, 2006 through November 30, 2006 , will you be able to:

1.  Yes_____ No _____ Attend weekly classes each Thursday from 9 a.m. until 1 p.m. ? 

2.  Yes_____ No _____ Attend monthly Demonstration Garden work days as scheduled (normally from 9 a.m. until 12 p.m. the third Monday of each month)? 

E.  During the Master Gardener Basic Training Class period (Part Two) from December 1, 2006 through November 30, 2007 , will you be able to:

 1.  Yes_____ No _____ Attend monthly continuing education meetings (normally scheduled from 9 a.m. until 12 p.m. the second Thursday of each month)? 

 2.  Yes_____ No _____ Actively participate in the monthly Demonstration Garden work days (normally scheduled from 9 a.m. until 12 p.m. the third Monday of each month)? 

 3.  Yes_____ No _____ Work in the Master Gardener office to fulfill this part of your requirement for volunteer service (a total of 40 hours scheduled in 4 hour blocks of time)? 

 4.  Yes_____ No _____ Participate in other projects as assigned? 

F.  To complete both parts of the Master Gardener Basic Training Program:

 1.  Yes_____ No _____ Do you understand you will need a minimum of 169 hours over a 15 month time period to fulfill your commitment? 

2.  Yes ___No ___ N/A ___ If you do not live in Leon County , do you understand that all training and volunteer service activities must be completed in Leon County and not in your home county? 

G.  SELECTION PROCESS AND FOLLOW-UP

 Following receipt of your completed application packet, you will be scheduled for an interview with a panel of Certified Master Gardeners.  You will be informed of your acceptance into the program within two weeks of the interview.  Please understand that since we are looking for the best prospective volunteers, not all applicants will be selected.  If you are not selected, your check will be returned.

 H.  COMMITMENT

 I have read and completely understand the requirements and commitments involved in the Master Gardener program.  I would like to be considered for the class which begins September 7, 2006 .

 ___________________________________________

                        (Signature)

 INSTRUCTIONS:

 THE APPLICATION PACKET

 Combine the following items to form the application packet:

             1.  A completed application form (pages one and two above).

            2.  A small current photo of yourself (head shot passport size is fine)

            3.  A check for $150.00 made payable to the “Leon County Extension Horticulture Fund”

 MAILING

 Mail the application packet to:

                        Master Gardener Application

                        Leon County Extension, UF-IFAS

                        615 Paul Russell Road

                        Tallahassee , FL 323

                        Remember:  All applications must be postmarked not later than July 31, 2006 . 

QUESTIONS

 If you have questions about the application process, please contact Zulema Wibmer at ZULEMAW@leoncountyfl.gov or call her at 606-5202.

 PRINTED 31 MAY 20006