Help Us Help You
Which Best Describes You?
Parent
School/University
Other
Student
Government/Health Department
Individual
Business
Contact Information
Name
First
Last
Company
Email
Street Address
City
Zip
State
Phone
Type of Program
School
Salad Bar
Fruit & Veggie Program
Fruit & Vegetable Vending
Wellness Policy
Schools Other
Business
Fruit & Veggie Store Events
Contests
Promotions
Business Other
Farmers' Markets
Program Description
Describe your program in 200 words or less:
Program Name
(e.g. Farmer's Market, School Veggie Party)
Select all that describe your program:
Interactive
Food preparation demonstrations
Fruit/vegetables available to eat
Educational entertainment
List all keywords that describe your program:
(e.g. kids, health fair, tour)
Program Date
(select one)
Date Range Begin
End
Recurring
Weekly
Bi-Weekly
Monthly
M
T
W
Th
F
Sa
Su
(e.g. 1st Monday)
Ongoing
Program Location
(select one)
Select location to your program
Nationwide
Statewide
Multiple City or County-Wide
One Location
Facility
Street Address
City
Zip
State
Multiple Areas: (copy/paste zip codes or
ask PBH for assistance
in uploading multiple listings)
Program Expectations and Challenges
What are the expected outcomes of your program? (100 Words or less)
What are the biggest challenges of your program? (100 Words or less)
Show Us! Upload
File 1:
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