Fundamentals for Farm to School / Child and Adult Care Food Program (CACFP) Application V2

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* 1. Name

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* 2. Email

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* 3. Organization / Agency name

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* 4. Title

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* 5. State/Territory/Sovereign Nation

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* 6. Based on the USDA FNS regional offices, which region does your organization serve?

Mid-Atlantic - (DE, DC, MD, NJ, PA, PR, VA, WV )

Midwest - (IL, IN, IA, MI, MN, OH, WI)

Mountain Plains - (CO, KS, MO, MT, NE, ND, SD, WY)

Northeast - (CT, ME, MA, NH, NY, RI, VT, VI)

Southeast - (AL, FL, GA, KY, MS, NC, SC, TN)

Southwest - (AZ, AR, LA, NM, OK, TX, UT)

Western - (AS, AK, CA, HI, ID, NV, OR, WA, GU, CM)

National

International

Other (please specify)

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* 7. Does your agency/organization work

Nationally / Multi-state

Statewide

Regionally within a state

Locally

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* 8. Which best describes your agency/organization?

Department of Agriculture (or equivalent)

Department of Education (or equivalent)

Department of Health (or equivalent)

Extension

Other (please specify)

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* 9. Which age groups does your agency/organization work with? (Check all that apply)

Early care and education (ECE, Pre-K)

K-12

I am not currently doing farm to school/institution work, but my organization has plans to begin

I do farm to institution work with other age groups (please specify age group and type of institution)

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* 10. Approximately how much of your full-time equivalent (FTE) is spent on farm to school/CACFP?

50%

100%

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 11. How long have you been conducting farm to school activities at your agency/organization?

Haven’t started yet but plan to soon.

Less than 1 year

1-2 years

3-5 years

6-10 years

More than 10 years

Rate your proficiency in the following:

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* 12. Agriculture

1 - No experience

3 - Somewhat proficient

5 - very proficient

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* 13. Agriculture education

1 - No experience

3 - Somewhat proficient

5 - very proficient

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* 14. Communications/marketing

1 - No experience

3 - Somewhat proficient

5 - very proficient

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* 15. Gardening at schools or CACFP sites

1 - No experience

3 - Somewhat proficient

5 - very proficient

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* 16. Local procurement

1 - No experience

3 - Somewhat proficient

5 - very proficient

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* 17. National child nutrition programs (e.g. NSLP, CACFP, SFSP)

1 - No experience

3 - Somewhat proficient

5 - very proficient

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* 18. Network building

1 - No experience

3 - Somewhat proficient

5 - very proficient

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* 19. Program evaluation

1 - No experience

3 - Somewhat proficient

5 - very proficient

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* 20. Running or being an educator at an early care and education site

1 - No experience

3 - Somewhat proficient

5 - very proficient

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* 21. Strategic planning

1 - No experience

3 - Somewhat proficient

5 - very proficient

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* 22. What do you hope to learn or gain from joining Fundamentals? What are the greatest obstacles you hope to overcome?

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* 23. What aspirations do you have for your farm to school programming?

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* 24. Is your organization/agency a current National Farm to School Network Partner?

Yes

I don't know

Demographics

Demographic data will not be used in the selection process and will be used for program evaluation.

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* 25. What race do you identify as? Select all that apply.

Asian/Asian American

Black/African American

Indigenous American/Native Alaskans

Hispanic/Latin/o/a/x/e

Middle Eastern or North African

Pacific Islanders/Native Hawaiian

White

Decline to state/Prefer not to answer

Write in

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* 26. What is your ethnicity?

Hispanics/Latin/o/a/x/e

Not Hispanics/Latin/o/a/x/e

Decline to state/Prefer not to answer

Write in