New Voices Application
What language(s) do you use most often at home?
Which of the following represent your racial or ethnic heritage? Choose all that apply.
African-American or Black
American Indian, Alaska Native, Indigenous or First Nations
Arab or Middle Eastern
Asian or Asian American
Hispanic, Latina, or Latino
Multiracial or Biracial
Native Hawaiian or Pacific Islander
White, Caucasian, or European American
Other (if you would like to specify)
What Zipcode do you live in?
What is your ( or your family's) Country of origin?
Which Group would you be interested in Joining?
Worcester Food Policy Council
Racism and Discrimination Working Group
REACH Advisory Committee-
Why would you be interested in Joining this Group?
Name & Best form of Contact
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This form was created inside of Coalition for a Healthy Greater Worcester.