Creating Your Kitchen Interest Form

The Arizona Department of Education (ADE) along with partners from the Chef Ann Foundation, Life Time Foundation, and Whole Kids Foundation look forward to supporting 10 Arizona Local Educational Agencies (LEAs) in a three-phase program to help operators reclaim their kitchens and menus as they recover from the impacts of the COVID-19 pandemic. The ultimate goal of the program is to guide LEAs to financial recovery, while laying the foundation for an operation rooted in fresh, whole ingredient based, scratch cooked food.

Please complete the form below no later than May 14, 2021 to indicate your interest and commitment to being one of the 10 LEAs that will work with our experts towards achieving your goals. ADE and partners will review all interest forms submitted by the deadline and will contact only those LEAs that are selected to move forward.

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* 1. Local Educational Agency (LEA) Name

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* 2. Contact Information

Name

Title

Email Address

Phone Number

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* 3. Tell us why you would like to participate in Creating Your Kitchen and how this project would enhance your LEA's operation of federal child nutrition programs.

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* 4. What are your current barriers to serve your "dream menu" or what have you not been able to implement as a result of your current kitchen capacity/operation capacity?

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* 5. Describe a change you have made to your menu that you are proud of.

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* 6. On a scale of 1-5, which best reflects your NSLP menu prior to COVID-19?

1 - Heat and Serve Only

3 - 50% Scratch Cooked

5 - 100% Scratch Cooked

1 - Heat and Serve Only

3 - 50% Scratch Cooked

5 - 100% Scratch Cooked

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* 7. On a scale of 1-5, which best reflects your desired future NSLP menu?

1 - Heat and Serve Only

3 - 50% Scratch Cooked

5 - 100% Scratch Cooked

1 - Heat and Serve Only

3 - 50% Scratch Cooked

5 - 100% Scratch Cooked

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* 8. I certify and attest that, to the best of my knowledge, this submission is true and correct according to the information available to me at the time of completion; and that by committing to this project, I am indicating I have sufficient authority and approval to proceed with the activities described below. I further certify and attest that in the case our entity is selected to participate, we agree to the following activities/requirements:

Submit a letter of support for this project from your LEA's administration (i.e. Superintendent or equivalent) and/or School Board

Attend the virtual Kick-off meeting on June 8, 2021

Complete an assessment and submit required documentation to the Chef Ann Foundation

Share all product labels with the Life Time Foundation and work towards eliminating the ingredients of concern from your menu

Provide documentation for purposes of research/evaluation of the effectiveness of the project interventions at meeting desired outcomes

Complete all of the School Food Institute courses

Allow Chef Ann Foundation and Arizona Department of Education staff on site at your school(s) for a one-day site visit

Work towards the goals outlined in the strategic plan, which may include recommendations to procure new equipment items, implement changes to staff schedules or responsibilities, etc., in a timely manner

Participate in on-going technical assistance check-ins and peer mentorship program

Attend the ScratchWorks Annual Gathering in April 2022

Creating Your Kitchen Interest Form

Question Title

* 1. Local Educational Agency (LEA) Name

Question Title

* 2. Contact Information

Question Title

* 3. Tell us why you would like to participate in Creating Your Kitchen and how this project would enhance your LEA's operation of federal child nutrition programs.

Question Title

* 4. What are your current barriers to serve your "dream menu" or what have you not been able to implement as a result of your current kitchen capacity/operation capacity?

Question Title

* 5. Describe a change you have made to your menu that you are proud of.

Question Title

* 6. On a scale of 1-5, which best reflects your NSLP menu prior to COVID-19?

Question Title

* 7. On a scale of 1-5, which best reflects your desired future NSLP menu?

Question Title

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* 9. Digital Signature: