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2. Name of Group/Individual/Business
3. Contact Person
5. 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”)

7. Group Name as You'd Like It to Appear on the Sign
9. Contact Email
10. Contact Phone Number
12. Contact Address
13. Address
15. City
16. State
17. Zip
19. Do You Already Have a Master Gardener Volunteer (MGV) Contact?

    1. Yes
    2. No

    If not, one will be provided.
20. If yes, who is your MG contact/coordinator volunteer?
    Name and Phone Number

22. We/I promise to maintain designated flower bed(s) or flower pot(s) from May 15, 2023 (or upon execution of this application if after May 15th) through November 1, 2023. This includes:

    Weekly weeding, trimming, deadheading of existing plantings; do not remove the existing ornamental grasses (in the flower beds)

    Adding additional plantings as needed - only annual flowers (not trees, shrubs, or perennials)

    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

24. Signature
    By typing your name into this field you authorize the City of Xenia to consider this an electronic signature.
25. Date
    Date
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field