Thank you for registering for our IN -PERSON Cook Along in partnership with the UAMS Culinary Medicine team. A drawing will be held to provide 20 people the opportunity to cook with us at the UAMS Culinary Teaching Kitchen on Thursday, January 25th at 6:00pm.

OK

*1.What is your first name?(Required.)

*2.What is your last name?(Required.)

*3.What is your gender?(Required.)

MaleFemalePrefer not to answer

*4.What is your race? (Mark all that apply)(Required.)

American Indian or Alaska Native

Asian or Asian American

Black or African American

Native Hawaiian or other Pacific Islander

White or Caucasian

Prefer not to answer

*5.What is your email address?(Required.)

*6.Within the past 12 months, you worried that your food would run out before you got the money to buy more?(Required.)

Always

Usually

Sometimes

Rarely

Never

*7.Within the past 12 months, the food you bought just didn’t last and you didn’t have the money to get more?(Required.)

Always

Usually

Sometimes

Rarely

Never

*8.I'm interested in learning more about the Southern Ain't Fried Sundays program.(Required.)

Yes

No

Note: Participants selected must come to the UAMS Culinary Medicine Teaching Kitchen located in the Center on Aging building at UAMS  (926 Jack Stephens Drive  Little Rock, AR 72204) on Thursday, January 25th at 6:00pm to participate.