Dakota County Public Health Department

Dakota County Public Health

Community Garden Mini-Grant Funding Interim Report

REPORT PURPOSE

Thank you for applying for the Dakota County Public Health Community Garden Mini Grant. We appreciate your time, enthusiasm, and interest! Please fill out the following report, which will be used to evaluate Dakota County’s achievements, successes and challenges related to the Statewide Health Improvement program (SHIP) grant. Information from this reporting form will be summarized and reported to the Minnesota Department of Health and the Minnesota Legislature, who funds this initiative. Please return to Shannon Bailey by: June 1, 2011 (Contact information on page 2).

This report should take about 10-15 minutes to complete.

Date:

Completed by: Role in the garden:

Contact Information (phone/e-mail):

Name of Community Garden:

Garden Location (address, city):

______Size of community garden (area or number of plots). Expanding gardens, please include size of expansion.

Is this a new or expanded community garden? (Circle one) New Expanded

______Number of total gardeners so far

______Number of new gardeners so far

______Number of new gardeners from the target population, [i.e. low income, Hispanic/Latino, African-American)

______Number of total gardeners from the target population, [i.e. low income, Hispanic/Latino, African-American)

What target population does this garden serve or plan to serve? Please check as many boxes as apply.

o Low-income o Hispanic/Latino o African-American
1. Has your plan for distributing at least 20% of the produce from this community garden to low-income and minority populations changed since your application?

Yes No

If yes, please describe how your plan changed including:

·  How decisions are made about what produce to distribute;

·  Who is responsible for distributing food; and

·  Agency name(s) and location(s) where the produce will be donated, if known.

2.  Please share a “success story” from your work so far? The story could be about the number of people working together, or how a gardener was impacted by learning new skills, or something from the day the garden was dug that we could share to show the importance of this work!

3.  Is there anything else we should know about your work?

In the final mini-grant report due on November 1, 2011, you will be asked to:

·  Describe the plan and progress toward this plan to keep this garden viable in the coming years

·  Show progress towards your goals as outlined in your mini-grant application

·  Describe any changes to the project plans and explain why they were needed (let Gardening Matters know when a change in project plans is needed)

Section III – Submitting Report

1.  Please return to Shannon Bailey by: June 1, 2011.

E-mail: or mail to: Shannon Bailey, Dakota County Public Health Department, 1 Mendota Road West, Ste. 410, West St. Paul, MN 55118-4771

2.  Questions? Contact Kelsey Barale at 612-821-2358 or Shannon Bailey at 651-554-6164. Thank you!

Gardening Matters, Mini-grant Interim Report Form. Page 2 of 2

Due June 1, 2011