| Name: __________________________________________________
Address: ________________________________________________
____________________________________ Zip: __________
Phone: Work:_________________ Home: _____________________
Fax: __________________ E-Mail: ____________________
1. List any previous Horticulture or gardening experience. You may attach a sheet.
2. Are you employed? Full time_______ Part time_______
Are you retired?_______
Present or previous occupations:______________________________
________________________________________________________
3. Do you have any medical condition, which may limit your participation in Master Gardeners for physical or outdoor conditions? Describe briefly.
_______________________________________________________
_______________________________________________________
4. Indicate times you can most likely volunteer, weekdays and weekends from 8:00 a.m. – to 8:00 p.m.
_______________________________________________________
_______________________________________________________
5. List your reasons for wanting to become a Louisiana Master Gardener. What do you think you can contribute to the group?
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
Classes will begin January 7, 2009
Please mail or fax the completed application by November 26, 2008 to:
2009 Master Gardener Class
511 Roussell Street
Houma, LA 70361
Fax: 985-850-4620
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