Virginia School Nutrition Program Events

This form is to advise the VDOE Office of School Nutrition Programs of any events, promotions, recognitions, or awards that can be attended or recognized on social media.

Question Title

* 1. Please enter contact information for the primary event coordinator/host.

First and Last Name *

Title/Position *

School Division or Program Sponsor *

City/Town *

ZIP/Postal Code *

VA Region (1-8)

Email Address *

Phone Number *

Question Title

* 2. Please enter the name and location of the event/activity/celebration/recognition.

Event Name/Title

Event Location (Name of School, e.g.)

Address

City/Town

ZIP/Postal Code

Question Title

* 3. Briefly describe the purpose of the event.

Question Title

* 4. Which of the following describes the event (select all that apply)?

Nutrition Education

Physical Activity Promotion

Farm to School

Food Samples/Taste Test

Cafe Event (i.e. National School Lunch Week, School Lunch Hero Day, etc.)

School-Level Event (i.e. Back to School Night, Jog-a-Thon, etc.)

Division-Level Event

Other (please specify)

Question Title

* 5. Please enter the event date(s).

Start Date

Date

End Date

Date

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* 6. What time is the event scheduled to begin/end?

Start Time

Time

AM/PM

End Time

Time

AM/PM

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* 7. Are you interested in inviting a representative from VDOE and/or USDA?

VDOE

USDA

Both VDOE and USDA

Not interested

Other (please specify)

Question Title

* 8. (Optional) Upload event documents.

Please upload any pertinent event-related documents. Examples include: Promotional materials, event details, etc.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Question Title

* 1. Please enter contact information for the primary event coordinator/host.

Question Title

* 2. Please enter the name and location of the event/activity/celebration/recognition.

Question Title

* 3. Briefly describe the purpose of the event.

Question Title

* 4. Which of the following describes the event (select all that apply)?

Question Title

* 5. Please enter the event date(s).

Question Title

* 6. What time is the event scheduled to begin/end?

Question Title

* 7. Are you interested in inviting a representative from VDOE and/or USDA?

Question Title

* 8. (Optional) Upload event documents.

Question Title

* 9. Please enter any additional comments or details here.