Colorado Food Policy Network - HEAL Summit 2017 Scholarship Application

We are so glad that you are interested in being part of the HEAL Summit 2017! The Summit will include a number of food-specific and COFPN-specific events and activities. To apply for a travel scholarship, please fill out the following application and we will respond to you after all applications are reviewed.

We will attempt to cover all requests, but depending upon the number of requests, we may offer partial scholarships. We encourage car-pooling! If you are planning on car-pooling and/or sharing a hotel room with a colleague, please coordinate with them before filling out this survey so only one person requests mileage and/or hotel.

Priority will be given to active members in the COFPN leadership council and work groups and to Summit speakers/presenters.

Question Title

* 1. Name (First and Last)

Question Title

* 2. Organization (if any)

Question Title

* 3. City

Question Title

* 4. Do you participate in:

COFPN Work Group

COFPN Leadership Council

I am part of none of the above

Question Title

* 5. If you participate in a work group, which one/s?

Farm to Institution

Healthy Community Food Assistance

Healthy Food Systems Retail

Land Access

Nutrition Incentives

Question Title

* 6. Do you participate in a local/regional food coalition? If so, which one? (e.g., Jefferson County Food Policy Council)

Question Title

* 7. Are you speaking or presenting at the Summit?

Yes

Question Title

* 8. What scholarships are you requesting? Click on all that apply.

Mileage

1 night in hotel

2 nights in hotel

Registration Fee