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Please describe the initiative or program:

Please describe how the initiative or program advances wellness and/or nutrition in your community and how it connects, interacts, or effects the larger food system?

Please outline how your organization has used policy, system, and environmental change to support the adoption, implementation, and sustainability of your project/program?

Policy change: policies are a formal written statement of positions. Can be laws, ordinances, resolutions, mandates, guidelines, regulations, or rules at the legislative or organizational level (e.g., tax on unhealthy food, zoning ordinances, school prohibiting unhealthy food in school fundraising events).

System change: change made to organizational processes or methods, involving the infrastructure of an organization or community (e.g., farm to school programs, providing locally grown procurement to food providers).

Environmental change: physical, observable change to the built, economic, and/or social environment (e.g., availability of healthy food choices at local restaurants, sidewalk accessibility).

Please outline the reach of your program (how many people has it or can it impact?):

Please include information on your program or initiative funding (if applicable):

Please list any outcomes information (health, economic, environmental, and/or social):

Please add any additional information:

Date of Submission

Salutation

Last Name:

First Name:

Title:

City:

State:

Work email address:

Please attach fliers, publicity, and resource materials you believe exemplify the initiative or program.