Applicant Name

Relation to Military Member

Mailing Address

City     State     Zip

E-mail Address

Military Member Name     

Branch of Military Rank

Deployment Period

Military ID #

Services You Will Be Needing (check as many as apply)

                lawn mowing        weed eating        tree trimming        tree pruning        aeration

                fertilizing                bed edging        weeding               maintenance        outdoor pest control

                other

How did you hear about the GreenCare for Troops Program:

I certify the above information to be true and correct. I understand my family will receive needed lawn and landscape services from selected volunteer landscape contractors in my community during the length of deployment, not to exceed one year. The types and breadth of services provided will be up to each individual landscape contractor.

Name Date