Cooking Matters 2019 Registration
Thank you for your interest in participating in our 6-week cooking course. Please take a few minutes to thoroughly fill out the course registration form. The form should take 5 minutes to complete. Upon completion, you'll be sent an email confirming your registration.
Note: If you want to take the course with a partner or spouse please note that if the class fills, you may be asked to have only one person attend so more people can take the course. Each participant must register separately.
All your information is confidential and will not be shared with anyone outside of HDFFA.
* Required
Cooking Matters is a skills building course and it is important that you commit to attending all 6 classes. Are you prepared to commit to all of the classes?
*
Yes, I can make all 6 classes
Yes, but I may miss one
Not sure, I may miss several classes
No, not at this time
Other:
Are you 18 years or older?
*
Yes
No
Are you SNAP eligible, use WIC or OHP? (aka food stamps, Oregon Trail)?
*
Yes
No, my income level is just above these programs.
These programs are not applicable to me.
Other:
I am registering
*
Myself
My partner/spouse
Someone else (please state your relationship in the "other" column)
Other:
First Name
*
Your answer
Last Name
*
Your answer
Email Address
Your answer
Phone Number
*
Your answer
Preferred Method of Contact
*
Email
Phone
Text
Required
Which cooking course are you interested in? (NEXT SESSIONS TBD FOR FALL 2019)
*
BEND- Dates TBD
LA PINE- Dates TBD
PRINEVILLE- Dates TBD
REDMOND- Dates TBD
WARM SPRINGS- Dates TBD
Other:
How did you hear about Cooking Matters? (check all that apply)
*
WIC or SNAP staff
My doctor or health care provider
Postcard
Flyer
Website
Social Media
Word of Mouth
Other:
Required
If your doctor or health care provider told you about it, please tell us which provider it was.
Mosaic Medical
St. Charles
La Pine Community Health Center
Direct from my primary care physician
Other:
Clear selection
Do you have any dietary restrictions, food allergies, or food preferences? (Check all that apply)
*
Gluten Free
Vegetarian
Vegan
Diabetic
Food Allergies (Please list in "other" section)
No, I don't have any food preferences/allergies
Other:
Required
Cooking Matters is a beginners cooking course. What do you feel like your current level of cooking knowledge is?
*
I don't know how to cook
I eat a lot of boxed or pre-packaged meals
I can cook a few simple recipes from scratch
I feel very comfortable in the kitchen
I love cooking and I cook everyday!
Other:
Required
What are the TOP TWO reasons you decided to enroll in Cooking Matters?
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Learn cooking skills
Free take home food
My doctor said I should
I want to eat healthier
Learn skills for job opportunities
Sounds fun
Other:
Required
If you feel you might miss a class, please explain why.
*
Childcare
Transportation
Work
I might forget
Other:
Required
Is there anything else you'd like us to know?
Your answer
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