MG New Project Request Form

✻ = Required

Your First Name: ✻

Your Last Name: ✻

Your Email address: ✻

Name of New Project (for example, SMCC Native Plant Garden): ✻

Location Name (if different from Project Name - for example, Santa Monica City College):

Street Address (If you don’t know an exact street address, you must provide a nearby address. Our funding reporting requires exact locations. Shelters may provide office locations or other nearby addresses instead of their actual locations in order to protect residents' safety and privacy): ✻

City: ✻

Zip Code: ✻

What location settings will be used for your project? ✻

Community Garden Farmers Market/Fair/Tabling Event School Garden Senior Garden Shelter Garden Virtual Workshop (NOT taking place at any of the sites described above) Other

If you selected "other" above, please provide a description of the location here.

Project Description and project educational goals (please give as much information as possible): ✻

How do you plan to accomplish the project? ✻

Project Contact: ✻

Approximately, how many Los Angeles County residents will this project serve (i.e. number of workshop attendees, size of class, etc.) ✻

Does the event take place on a single date or over the course of several dates? ✻

One-time event/Single Date Ongoing/Multiple Dates

Event Date/Event Start Date (if ongoing): ✻

Completion Date (if known). If the event is open-ended please type in "ongoing":

I understand that to qualify for volunteer hours, time must be spent in an outreach or educational capacity (i.e. teaching, demonstrating, tabling). Volunteer hours can not be counted for general garden maintenance nor labor (i.e. weeding, mulching, etc.).

Labor and garden maintenance for volunteer hours is only allowed at our partner sites or if pre-approved by UCMG staff. ✻

Yes No

UCMG Statewide Program Evaluation: MGs giving workshops or presenations lasting over 15 minutes must give participants the option to opt into a follow up survey provided by the statewide office. Please check "yes" below indicating that you will promote the survey during your workshop. ✻

I understand Does not apply to me

MG New Project Request Form - Updated