OHIO STATE UNIVERSITY EXTENSION Title OSU Extension SNAPEd

OHIO STATE UNIVERSITY EXTENSION Title OSU Extension SNAP-Ed Adult & Parent Curriculum Document Sub head 1 HOST SITE INFORMATION SHEET / CHECKLIST Host Site / Organization Information: ______________________________ Host Site/Organization Name Street Address __________________________________ City County State Zip __________________________________ Host Site Contact Person: Name & Phone Number __________________________________ Day of Class: Host Site Point Person: Name & Phone Number Dates of series: ___________________________ How would you classify the organization? Please check: q Faith Based Institution q Community Center q Health Clinic/Center q Wellness Center q Other: _______ NOKIDHUNGRY q Food Pantry q Housing Development Describe the Space: ______________ q Participants are SNAP eligible

OHIO STATE UNIVERSITY EXTENSION Title OSU Extension SNAP-Ed Adult & Parent Curriculum Document Sub head 1 Checklist: Minimum Requirements for Host Site Class Space Please confirm/check: q q q q Refrigeration for perishable groceries Hot Running Water Sink large enough to wash dishes Working electrical outlets Work space sizable enough for all participants to prepare recipes Enough tables and chairs to accommodate entire group The space is far enough away from potentially distracting activities Host site has identified a committed site contact/ point person for during classes. Point person helps to set up class and greet participants. Point person has an understanding of needs of the class. ** A heat source is not a requirement for the space, but it is however a requirement for the course. Resource Sharing: Will host site be providing resources? Resource sharing is encouraged, not required. q No NOKIDHUNGRY q Yes Please check and provide description of resources host site to provide: q All Kitchen Equipment (bowls, plates, utensils, cooking equipment) q Some Equipment: __________________________

OHIO STATE UNIVERSITY EXTENSION Title OSU Extension SNAP-Ed Adult & Parent Curriculum Document Sub head 1 Resource Sharing: Please check resources to be provided by host site q Food: (In-Class Ingredients for Recipes/ Take-Home Groceries) Describe: _________________________ q Shopper q Class Assistant q Voluntary Culinary Instructor q Volunteer to Assist: Describe: _________________________ q Childcare q Transportation q Participants Was a grant secured to host OSUE SNAP-Ed Cooking Matter Series at the site? q Yes Describe: ________________________ q No NOKIDHUNGRY Is the site providing funding? q Yes Describe: ________________________ q No Is the site providing other resources? Describe: _________________________