Garden-To-Go Kit Interest Form

✻ = Required

Please fill out the below form if you are interested in being contacted about the Garden-To-Go Kits. Please note that we are in the pilot stage of distribution and we will contact you as soon as possible with availability.

First Name ✻

Last Name ✻

Email ✻

City of Residence ✻

Are you a ✻

Parent Teacher Student Other

What school are you affiliated with? ✻

What grade do you teach? ✻

How many Garden-To-Go Kits would you need?

If you received the Garden Kits, would you be interested in the TWIGS Curriculum through Cal Fresh Healthy Living (we would facilitate the first session through zoom and provide you with the remaining virtual curriculum) This lesson is geared towards K-6th grade. ✻

Yes, I would like to have Farm Smart and Cal Fresh Lead a Zoom Session No, I would like to lead my own lesson with the kits.

Are you willing to share pictures of your students' plants and garden journals throughout the growing process? ✻

Yes No

Would you be open to providing feedback on the Garden Kits and Lesson? ✻

Yes No

Please specify your ethnicity (check all that apply) ✻

Caucasion African-American Latino or Hispanic Native American Native Hawaiian or Pacific Islander Prefer not to say

Age (please select all ages that will be participating with you or that you are registering for) ✻

0-15 15-30 30-45 45+ Prefer not to answer

In the last year, have you or other household members participated in WIC, SNAP (CalFresh), EFNEP, Head Start, Food Pantry, free or reduced-price school breakfast/lunch/supper/summer meals? ✻

Yes No