FRESHstart Kitchen Application Question Title * 1. Please fill out the entire application from start to finish. No answers to any of the questions in the application will deny you from the program. An application will not be turned down for the FRESHstart Kitchen solely because of a conviction of a crime unless it is a crime against children or a crime of sexual circumstances. I understand Question Title * 2. Please enter your full legal name Question Title * 3. Please enter your date of birth Date / Time Date Question Title * 4. What is your T-Shirt size? Small Medium Large XL 2-XL Other (please specify) Question Title * 5. Where did you hear about the program? Question Title * 6. Phone Number Question Title * 7. Please enter a valid email address Question Title * 8. What is the best method to reach you? Phone Email Question Title * 9. How do you identify? Man Non-binary/third gender Woman Prefer to self-describe Prefer not to answer Question Title * 10. Are you currently a U.S Citizen? Yes No Question Title * 11. What is your preferred language? English Spanish Other (please specify) Question Title * 12. Are you vaccinated against COVID-19? Yes No Question Title * 13. What is your Race/Ethnicity? Asian Black or African American Hispanic or Latino Middle Eastern or North African Native American or Alaskan Native Native Hawaiian or Other Pacific Islander White Multiracial Other (please specify) Question Title * 14. What is your age? 18-25 26-35 36-45 46-55 56-64 65 or older Question Title * 15. How many adults live in your household (individuals aged 18 or older, please include yourself) 0 1 2 3 4 5+ Question Title * 16. How many children live in your household (individuals aged 17 or younger) 0 1 2 3 4 5+ Question Title * 17. Are you a veteran or active military? Yes No Next