MENDOCINO COUNTY MASTER GARDENER APPLICATION

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					                           MENDOCINO COUNTY MASTER GARDENER APPLICATION
Please print or type. Use the name you would like to be called by within the Master Gardener organization:

Name_____________________________________________________________________________________

Home Address _____________________________________________________________________________
                         Number and Street                  City                               ZIP

Mailing Address____________________________________________________________________________
(If not same as above)      P.O. Box or Number and Street

Preferred phone number ___________________ Alternate phone number ______________________

Email address _____________________________________________________
(Re quired)

1. How long have you been gardening?___________ What gardening experience do you have?

________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

2. List areas of special interest related to gardening.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

3. List garden group affiliations, if any.
________________________________________________________________________________________

4. What is the highest level of education you have completed? What were your fields of study.
________________________________________________________________________________________
________________________________________________________________________________________

5. What is your current/past employment?
________________________________________________________________________________________

Do you expect to be employed in the next year?_______ How many hours per week?_____________

6. Briefly summarize your work experience.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
7. Briefly summarize your volunteer experience.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

8. What times of the are you most available to volunteer?
Monday: a.m. ___ p.m.___ Wednesday: a.m. ___ p.m. ___ Friday: am___ p.m.___
Tuesday: a.m. ___ p.m.___ Thursday: a.m. ____p.m. ___ Saturday: a.m. ___ p.m. ___

9. What special skills would you bring to the program? (artistic, computer skills, arts and crafts construction,
   Photography, finance, teaching):__________________________________________________________
 _______________________________________________________________________________________

10. What teaching / communication experience do you have? List type of experiences:
      a. Writing articles___________________________________________________________________
      b. Speaking to large groups (30+ people)_________________________________________________
      c. Speaking to small groups (<30 people)_________________________________________________
      d. Demonstrations to groups.___________________________________________________________
      e. One-to-one consultations____________________________________________________________
      f. Educational art displays_____________________________________________________________
      g. Other (please describe)_____________________________________________________________

11. Have you applied to be a Master Gardener before? ______ When? __________ Where?_____________

   What are your expectations of being a UCCE Master Gardener? _________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________


12. Why do you want to be a Master Gardener?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
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I understand that, if accepted, I will not become a certified Master Gardener until I satisfactorily complete the training course, score at least 70% on the examinations,
complete the livescan requiremts and fulfill the intern requirements: 50 hours on approved Master Gardener activities. To remain in the Master Gardener program each
year I must complete 25 hours of volunteer service and 12 hours of continuing education. I must submit monthly records of my volunteer hours via the VMS computer
program. I also understand that there is a training fee of $200. I am committed to community service in Mendocino County and am willing to act as an agent of the
University of California Cooperative Extension. I agree to comply with the requirements delineated in the UCCE M aster Gardener Program Administrative Handbook.

Signature____________________________________________________Date _________________________

				
DOCUMENT INFO
Jun Wang Jun Wang Dr
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