Community Greening Award

Community Greening Award Nomination Form

Fill out the form below to nominate a garden or other green space for the PHS Community Greening Award.

Contact Information

Q.1

Your Name *

Title

First Name

Last Name

Q.2

Your Address *

Address Line 1

Address Line 2

City

State

Zip Code

Q.3

Your E-mail address *

(e.g. john@example.com)

Q.4

Your Phone Number *

(e.g. 1 201-234-5678)

Information about the Site

Q.5

Name of Nominated Site

Q.6

Type of Public Green Space *

Q.7

Year Site Established

Q.8

Address of Nominated Site *

Address Line 1

Address Line 2

City

State

Zip Code

Contact Information for Garden Representative

If you are not an official representative of the green space you are nominating, please provide contact information for such a person.

Q.9

Contact Person's Name

Title

First Name

Last Name

Q.10

Contact Person's Address

Address Line 1

Address Line 2

City

State

Zip Code

Q.11

Contact Person's E-mail Address

(e.g. john@example.com)

Q.12

Contact Person's Phone Number

(e.g. 1 201-234-5678)