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Food Literacy Academy 2017 Application

November 10, 2015

Submit your application online!

Please note that Food Literacy Center has a grant which requires us to capture demographic information about participants in our training. Your information will be kept confidential. Thank you for your time!

Contact Information

First Name: *

Last Name: *

Date of Birth : *

E-mail: *

Mailing Address : *

City : *

Zip Code: *

Primary Phone Number : *

Demographic Information

Occupation and Title : *

Ethnicity: *

Gender : *

What is your first language?: *

What other languages can you speak?: *

Indicate your level of understanding on a scale from 1 to 5 (1 = minimal understanding and 5 = fluent).

Please answer the following questions:

1. Why are food and food literacy important to you? : *

2. Please describe a memorable food experience (cooking with your grandma, preparing a balanced meal, teaching a friend about gardening, touring a farm, creating a recipe, etc.):: *

3. What do you expect to take away from the Food Literacy Academy?: *

4. How do you plan to use your knowledge as a Food Literacy Advocate in your community?: *

5. What professional skills will you bring to the program? (writing, cooking, recipe development, teaching, gardening, accounting, fitness, PR, social work, etc.): *

6. What volunteer experience do you have? And with what organizations? (Please note that experience is not required. We are simply curious to hear about other work you have done or are doing.): *

7. Have you been involved in any projects or activities in your community? (Again, experience is not required.): *

8. How much time will you be able to commit to volunteering in your community after graduation from the Food Literacy Academy? Where do you hope to volunteer? : *

9. Do you have experience working with youth? : *

10. If you answered yes to #9, please explain in what capacity and with what organization.: *

11. How would you advise a single parent with two teenage children who wants to provide healthy meals for her family?: *

12. You arrive to teach a class of foster youth about homemade food versus fast food. When you begin the class you ask, "What is cheaper, fast food or homemade food?" and the youth respond, "Homemade food!" Your entire lesson plan revolved around teaching them about the financial benefits of making food at home. How do you move forward from this moment?: *

13. Please describe a time when you demonstrated dedication. : *

14. Cost of training: $500. A limited number of scholarships are available. If you would like to be considered for a scholarship, or partial scholarship, please write a brief statement describing your need. :

15. If you are applying for a scholarship, please check the box that best describes you::

I am only able to attend this training if I receive a full scholarship.

I am able to attend this training if I receive a partial scholarship

If I do not receive a scholarship, I am still interested in attending this training and willing to pay the full $500 course fee.

If I receive a partial scholarship, I am able to pay $________:

Answer if you selected “partial scholarship” to question 15.

Agreement and Signature

Date : *

Signature : *

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