Contact Name *
Name of affiliated company, if any
Contact Email *
Contact Phone
Website
Which policy issues reflect your expertise? (select all that apply)
Please indicate if you have expertise in any of the following topics (select all that apply): *
Do you have experience with any of the following? (select all that apply): *
At what level do you have experience working? (select all that apply) *
Where have you worked? Specify the city, region, state, Native American or First Nations community or country.
Have you previously worked with food policy councils or similar entities? *
List the name and state for the food policy councils or similar entities that you have worked with.
Do you speak any languages other than English?
Please provide (1-2) references for your work.
Please provide a brief description (1-2 sentences) of your services that we can share with interested food policy councils.