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* 1. Name of Organization

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* 2. Name of Program (if different than organization name)

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* 3. Mailing Address

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* 4. FMNCP Primary Contact

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* 5. FMNCP Secondary Contact

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* 6. The following criteria are necessary to be a program partner. Please check all that apply to your organization:

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* 7. The program operates between early June and October. Please list any dates during that time when your offices are closed for an extended period of time.

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* 8. If there are any closures, how will you manage the Program during that period?

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* 9. If you were participating last year...

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* 10. If this is the first time you are applying...

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* 11. Below are the expectations and responsibilities that come with administering the FMNCP program. Please check all that you are able to meet.

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* 12. Please list any other community partners who you will engage with for the FMNCP (include partners who may deliver food literacy activities, distribute coupons, provide referrals to the program)

Questions 13-15: BUILDING FOOD LITERACY (i.e. workshops and classes on budgeting, cooking, preserving, reading food labels, etc.).

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* 13. Do you provide activities that help build food literacy?

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* 14. If yes, please tell us what you offer (e.g. workshops and classes on eating on a budget, cooking, preserving, reading food labels, etc.)

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* 15. In addition to / in lieu of formal programs, what else will you do to increase food literacy of participants?

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* 16. Do you have (or anticipate) any local funding to support additional households to join the program? Please provide any details.

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* 17. Which farmers market(s) are you working with?

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* 18. If you participated in the program last year, please let us know about any challenges and how we can better support you this year.

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* 19. The FMNCP is stronger in a community when the farmers market and the community partner coordinate, collaborate, communicate and work together. Please describe how you will work together to make the program successful.

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