First name *
    Last name *
    Email *
    Phone Number
    District or Organization *
    City *
    Zip Code *
    Please check the workshop that you plan to attend: *
    San Jose – March 14, 2012Oakland – February 15, 2012San Diego – February 23, 2012
    How did you find out about Nourish? Check all that apply:
    Word of mouthFriend/colleagueYour school/districtAnother non-profit or community organizationInternet searchWebsitePBS broadcast
    We would like to make sure we customize each workshop to the specific audience. Please let us know a little more about you.
    What is your occupation? Check all that apply:
    TeacherAfterschool educatorSchool garden coordinatorHealth and wellness professionalSchool administratorFood service staffFarm-to-school advocateNon-profit service provider working in K-12 schoolsNon-profit service provider not working in K-12 schoolsGovernment agency workerInformal educatorParent
    What grade level do you teach? Check all that apply:
    What subject area(s) do you teach? Check all that apply:
    General EdScienceSocial StudiesLanguage Arts/EnglishMathHealthP.E.
    What type of school do you teach in?
    How many years have you been teaching? Check one:
    1 year1-3 years4-9 years10+ years
    How would you rate your level of knowledge about food system concepts, from 1 (no knowledge) to 5 (extensive knowledge)?
    Have you used Nourish materials? If yes, please explain.
    Is there anything specific you are hoping to learn from the workshop?

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