"*" indicates required fields Name* First Last Email* Phone*Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Garden Boxes Requesting*Place box numbers below otherwise one will be assigned for you.Community Garden Box Policy* I agree to the guidelines for participating in the Harrisville City Community Garden.The Community Garden boxes are available upon request on a first-come first-serve basis as a free benefit to the residents of Harrisville City. The applicant(s) are required to keep the boxes neat and clear of debris for the whole of the growing season. Applicants are responsible for cleaning, preparing, watering, etc. of assigned garden boxes before, during and after the growing season. By checking this box you agree to respect the other residents using this service and will keep your box clean and well groomed throughout the gardening season. Also, you agree to clean out your box by November 1 in preparation for the next season. Δ