gap season application

GROW WITH US!

Please complete the following application to be considered for Garden City Harvest's Gap Season Program.

PERSONAL INFORMATION
Home Phone
Home Phone
Cell Phone
Cell Phone
Desired Start Date *
Desired Start Date
Date of Birth *
Date of Birth
How old will you be if you begin the course on your desired start date?
High School Phone
High School Phone
FIRST PARENT/GUARDIAN INFORMATION
Home Phone - Parent/Guardian 1
Home Phone - Parent/Guardian 1
Cell Phone - Parent/Guardian 1
Cell Phone - Parent/Guardian 1
Include guardian on email communications? *
SECOND PARENT/GUARDIAN INFORMATION
Home Phone - Parent/Guardian 2
Home Phone - Parent/Guardian 2
Cell Phone - Parent/Guardian 2
Cell Phone - Parent/Guardian 2
Include parent/guardian on email communications?
ADDITIONAL INFORMATION
Do you know how to ride a bike? *
Will you need to rent a bicycle while here? *
How did you hear about us? *
Tell us how you heard about us!
SHORT ANSWER QUESTIONS
REFERENCE
Please list a teacher whom we can write for a reference. We will email your teacher with a form to fill out to help us understand a bit more about you, the way you learn, and how your personality will fit with our programing.
MEDICAL HISTORY
Have you experienced any of the following? *
If yes, please explain below.
Yes or No? If yes, please explain.
Have you ever been *
Please check all that apply and explain below.
If you do not have food allergies, please write "None."
Do you follow a special diet? *
Check all that apply.