Name of Organization

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* 1. Name of Organization

Name of Program (if different than organization name)

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

Mailing Address

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* 3. Mailing Address

FMNCP Primary Contact

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* 4. FMNCP Primary Contact

FMNCP Secondary Contact

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* 5. FMNCP Secondary Contact

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

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

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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* 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.

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

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

If you were participating last year...

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

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

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

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

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

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

Questions 12-15: BUILDING FOOD LITERACY (i.e.: workshops and classes on budgeting, cooking, preserving, reading food labels, etc.).
Please list your Food Skills Literacy Programs:

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* 13. Please list your Food Skills Literacy Programs:

Who participates?

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* 14. Who participates?

Please describe the Program(s):

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* 15. Please describe the Program(s):

In addition to / in lieu of formal programs, what else will you do to improve the food literacy of participants?

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

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

Which farmers market(s) are you working with?

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

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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* 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.

For community partners who receive honorariums, you have the option to convert those funds into more coupons for your community.

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* 20. For community partners who receive honorariums, you have the option to convert those funds into more coupons for your community.

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