Cooking Matters Sign-Up Sheet
Preferred Method of Contact
Are you 18+ years old?
Which Cooking Matters Course are you interested in?
Bend @ THIS COURSE IS FULL- YOU WILL BE ADDED TO A WAIT-LIST
La Pine @ LaPine Family Kitchen, Mondays 4-6pm, April 23 - June 11
Madras - THIS COURSE IS FULL- YOU WILL BE ADDED TO A WAIT-LIST
Prineville @ COCC Open Campus, Wednesdays 5-7pm, April 11 - May 23
Redmond - THIS COURSE IS FULL- YOU WILL BE ADDED TO A WAIT-LIST
Warm Springs TBD
Did you hear about this program through a healthcare provider?
If "yes" to the above question, which provider?
La Pine Community Health Center
Direct from my primary care physician
If "no" to the above question where did you hear about the program?
How did you hear about Cooking Matters? (check all that apply)
Word of Mouth
Do you have any dietary restrictions, food allergies, or food preferences?
No, I don't have any food preferences/allergies
Do you foresee any barriers to attending all 7 classes?
Forgetting about the class
I have no barriers to attending
Do you need help overcoming barriers to attending class?
What are the TOP TWO reasons you decided to enroll in Cooking Matters?
Gain culinary skills
Free take home food
My doctor said I should
I want to eat healthier
Gain skills for job opportunities
Would you be interested in getting your food handlers card?
Yes, I would like to use CM to help me with future employment
No Thanks, I'm taking the course for other reasons
Cooking Matters is a 7 week long cooking course. Are you prepared to commit to all of the classes?
Yes, I can attend all 7
Yes, but I think I will miss a few
Not sure, I have some barriers to attending
No, my schedule changes a lot
Please tell us anything else or submit any questions that you have regarding the course.
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