Community Name:
*
School Name:
*
Contact Name (Main Point of Contact):
*
Approximate Number of Students:
*
Does your location currently experience issues with food quality or access to fresh produce?
*
Yes
No
Sometimes
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Does your school currently offer agriculture, food studies, or land-based education?
*
Yes
No
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Would Willow Brook’s Agriculture Education Portal benefit the youth and community leaders in your area?
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Yes
No
Unsure
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Do you have at least 20 ft x 20 ft of indoor space available for this project?
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Yes
No
Space could be created
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Does your location have access to fresh water and power?
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Yes – Both
Yes – Water only
Yes – Power only
No
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What tower package best suits your location’s needs?
*
6-Tower Package
12-Tower Package (Recommended for schools with over 50 students)
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Would your school/community be open to sharing your agriculture journey with Willow Brook Farms to help inspire others through your food sovereignty experience?
*
Yes
No
Possibly
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Name, Phone Number, and Email of the Community Leader for the Lights On Movement:
*
Name
Phone
Email
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