Maine Harvest for Hunger Enrollment Form

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Name:

Street:

Town/City:

Zip Code:

County: Androscoggin Aroostook Cumberland Franklin Hancock Kennebec Knox Lincoln Oxford Penobscot Piscataquis Sagadahoc Somerset Waldo Washington York

E-Mail:

Phone:

What is the best way to send you information?
E-Mail  Surface mail

I'm interested in (please check all that apply):

Growing extra food in my own garden.
Growing food in a community garden to donate.
Harvesting extra crops (gleaning) from farmer's fields.
Collecting and distributing food donations from my local farmer's market.
Educating myself and others about food insecurity in Maine.
Farmers: support gleaning activities either in the field or at a farmer's market.
Employers, Civic Organizations & Schools: engage your employees/members/students in any of these activities.

If you indicated that you would like to help in a community garden, do you need to be matched with a community garden to volunteer in? Yes  No

If you indicated you would like to glean, how far would you be willing to travel (one way)?

I would need a ride
Less than 10 miles
10 - 20 miles
20 - 50 miles
Over 50 miles

Please mark the most appropriate statement:
I already know where I can donate produce.
I would like information about where to donate produce.

Submit   Clear
(by pressing SUBMIT, your information will be automatically sent to Cooperative Extension; your contact information will not be shared.)

Questions? Please contact us by e-mail at barbara.murphy@maine.edu. Phone: (207) 743-6329 or 800-287-1482 (toll-free in Maine).