Food Safety Training for Partner Agencies Question Title * 1. Does your program have at least one person with a valid Food Safety Certificate on file? Yes (Training is required every three years, check the issue date on the certificate before proceeding) No (Please proceed) Question Title * 2. Choose a Food Safety Training Date: (Training is held at the Mid-Ohio Foodbank) November 4, 2016 1:30 pm - 4:00 pm Question Title * 3. Attendee Name (Limit 2 per session): Question Title * 4. Agency Name: Question Title * 5. Agency ID Number: Question Title * 6. Type of Program (click the drop down box) Pantry Soup Kitchen Cooking Group Shelter Youth/Adult/Senior Residential Program Day Care Center Youth or Camp Program Adult Group Home Produce Market or Fresh Foods Question Title * 7. County: Question Title * 8. Contact Phone Number: Question Title * 9. Contact Email: Done