Thank you for your interest in working with Leah's Pantry and (our online resource for CalFresh eligible populations)! Please complete this survey to help us better understand how we can support your organization in promoting healthy cooking and nutrition. We will follow up with you within a few weeks.

* 1. Your contact information:

* 2. Organization website:

* 3. How did you hear about Leah's Pantry? (Check all that apply.)

* 4. My organization serves (select all that apply):

* 5. What languages do your clients speak?

* 6. Is your organization SNAP-Ed funded?

* 7. Briefly describe your organization's primary programs. What has worked well in promoting health and wellness to your clients?

* 8. Please select the statement that best applies to your organization:

* 9. Does your organization have barriers to implementing nutrition education programs? If so, select the barriers that apply:

* 10. What are the most important nutrition questions that you and/or your clients have?

* 11. How often are you utilizing or promoting tools with your clients and/or colleagues? (e.g. using the tools at workshops or health fairs, to look up recipes for classes, to extend your programming, etc.)

  Daily Weekly Monthly Not at all Planning to use/promote Want to learn more about Mini Course Weekly Email Health Tips

* 12. What social media platforms, if any, does your organization actively use?

* 13. Do you have wifi or computers with Internet connection for public use at your site?

* 14. Do you have televisions or monitors to play videos (either via DVD or by streaming on the Internet) in your waiting room, lobby, computer lab, or any public space?

* 15. Indicate your relative confidence and experience level with each topic below.

  Very confident Somewhat confident Looking for additional support/training Not confident
Basic Nutrition
Preventing Chronic Disease
Workshop Facilitation
Cooking with a Group
Introducing/Using Online Tools

* 16. Leah's Pantry also provides training and support for organizations to run in-person curriculum, Food Smarts. Please select all that apply:

Thank you for taking the time to complete our Partner Registration! We will follow-up soon and add you to our Leah's Pantry and newsletters.