Adopt-A-Spot Application

2. Name of Group/Individual/Business

3. Contact Person

5. Contact Email

6. Contact Phone Number

8. Contact Address

9. Address

11. City

12. State

13. Zip

15. Do You Already Have a Master Gardener (MG) Contact?

    1. Yes
    2. No

    If not, one will be provided.

16. If yes, who is your MG contact/coordinator?

    Name and Phone Number

18. We/I promise to maintain designated flower bed(s) or flower pot(s) through November 2018. This includes:<br><br>Weekly weeding, trimming, deadheading of existing plantings<br>Adding additional plantings as needed - can be annuals, bulbs, or perennials (not trees or shrubs)<br>Flower beds and flower pots should be watered regularly, especially during periods of intense heat or during prolonged periods when regular precipitation does not occur (the City will assist with routine watering during regular working hours)<br>Weekly trash, debris pick up/clean up

    We/I promise to maintain designated flower bed(s) or flower pot(s) through November 2018. This includes:
    
    Weekly weeding, trimming, deadheading of existing plantings
    Adding additional plantings as needed - can be annuals, bulbs, or perennials (not trees or shrubs)
    Flower beds and flower pots should be watered regularly, especially during periods of intense heat or during prolonged periods when regular precipitation does not occur (the City will assist with routine watering during regular working hours)
    Weekly trash, debris pick up/clean up

20. Signature

    By typing your name into this field you authorize the City of Xenia to consider this an electronic signature.

21. Date
    Date

23. An acknowledgment sign will be provided with your name/group/business stating

    Adopted by (Please provide correct spelling, please print clearly, and please be brief! Example “The Jones Family” or “Girl Scout Troop 122”)

    Adopted by (Please provide correct spelling, please print clearly, and please be brief! Example “The Jones Family” or “Girl Scout Troop 122”)

25. Group Name as You'd Like It to Appear

Leave This Blank:


26. 1. Receive email copy
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field