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Thank you for your interest in the Penn State Extension Master Gardener Program in Elk & Cameron Counties! Please fill out the application below to be considered for our next training class. If you have any questions regarding the application, please contact Amanda Balon, Master Gardener Coordinator Elk/Cameron Counties arb334@psu.edu 814-776-5331

Filling out this application does not guarantee acceptance into the Master Gardener Program. Answers to questions like prior gardening experience, education, or occupation will not help or hurt your chances of becoming a Master Gardener - they just help us learn more about you. After submitting your application, you may be contacted to schedule an interview to fully determine if you'll be a good fit for the program.

The cost for the Master Gardener training program is $250. This includes the latest edition of the of the Penn State Extension Master Gardener Manual.

The Pennsylvania State University encourages qualified persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact the Extension Office at 814-776-5331 in advance of your participation or visit.

This application is available in alternative media on request.

First and Last Name

Email Address

Phone Number

Home

Cell (if different)

County of Residence

Mailing Address

Street or PO Box

City

Zip Code

Physical Address (if different from Mailing)

Street

City

Zip Code

Occupation

Employment Status

Full Time
Part Time
Retired
Other

Years of Gardening Experience

Please list any training or work experience in horticulture or related fields:

Please indicate your schooling (check all that apply):

Please list areas of interest or specialization (i.e. vegetables, flowers, roses, writing, speaking, etc.)

How did you learn about the Master Gardener program?

What are the best days or times for you to do volunteer work?

List times during the next year that you will NOT be available for volunteer service (vacation, job, other commitments):

In 150 words or less, tell us why you want to become a Master Gardener:

Please rate the following activities/areas where you may want to volunteer:

Please rate the following activities/areas where you may want to volunteer:
	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Teach/present to small groups	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Teach/present to large groups	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Teach/work with youth	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Teach/work with adults	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Teach/work with senior citizens	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Teach/work with persons with physical disabilities	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Answering gardening questions from the public	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Write gardening articles for website or print publications	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Staff information booths	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Prepare exhibits and displays	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Plant and maintain demonstration gardens	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Coordinate volunteer activities	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Plan educational programs	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Carpentry/handiwork	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Judge horticultural exhibits/entries for fairs	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Provide art or design services	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Work on publicity for events	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!
Other (please specify)	No interest	A little interest	Moderate Interest	Very interested	I would love to do this!

By checking this box, I certify that I wish to become a Penn State Extension Master Gardener volunteer and would like to be accepted into the training program. I understand that if accepted, I will attend the required training sessions and agree to volunteer at least 50 (fifty) hours by end of Sept. of each program cycle.

Yes, I understand.