Contact Us

Sherry Thomas
1615 Commerce Parkway
Bloomington, IL 61704
Phone:
FAX: 309-663-8270
sgthomas@illinois.edu

Online Forms & Surveys

Master Gardener Application

We are excited to have you apply for the Master Gardener Program. This application is for the Master Gardener Program in Livingston, McLean & Woodford Counties.

* First Name
* Last Name
* Street
* City
* State
* Zip Code
* Home Phone
* Email

*Sex



*Residence - Please choose one of the following choices.






Race - Please select one or more.





Other:

Ethnicity - Please select one.



*Have you had any previous affiliations with University of Illinois and/or Extension?
    

If answered yes to the previous question, please describe.

*Why do you want to become a University of Illinois Extension Master Gardener?

*Are you available for classroom training during regular business hours?
    

*Are you available to volunteer time during regular business hours?
    

*Have you been in another Master Gardener Program?
    
If answered yes to the previous question, please answer where and when.

*Describe your present and previous work experience including employer, job title, and number of years.

*Describe volunteer roles with any other community groups. Please list current or most recent experience first. Include the organization, volunteer role, and the number of years working with the organization.

*Briefly state your gardening interests; such as vegetables, flowers, herbs, etc.

*Do you have any teaching experience with children or adults; either in a formal classroom, one-on-one in the garden or in other settings?
    
If answered yes to the previous question, please describe

Do you know anyone who is already a Master Gardener? If so, please list name(s).

Do you need any assistance (financial, physical, accommodation, etc.) to participate in this program? If so, please describe.

Please list any special skills (computer, art, writing, photography, etc.) which you would like us to know about.

*Have you ever been convicted of a criminal offense?
    
Please note that a conviction will not necessarily disqualify an applicant. A conviction will be considered as it relates to the specifics of the position for which you have applied.

*I authorize the University of Illinois to contact the State Police for a criminal investigation, the Illinois Department of Children and Family Services to conduct a search of the Child Abuse and Neglect Tracking System and other sources as necessary.
    

*I understand that I must be officially accepted before beginning my volunteer position. I understand that misrepresentation or omission of facts requested in this application is cause for rejection as an Extension volunteer. I agree to fulfill the responsibilities of this volunteer position to the best of my ability if appointed. I understand that failure to comply with the rules may lead to dismissal from this position.
    
Thank you for taking the time to fill out the Master Gardener Application. If you have any questions, please contact Sherry Thomas at sgthomas@illinois.edu or (309) 663-8306.

*Indicates questions that require an answer.