OHIO STATE UNIVERSITY EXTENSION

Document TitleSub head 1

OSUE SNAP-Ed Adult & Parent Curricula

 

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:

Food Pantry Church/Faith Based Community Center Health Clinic/Center Wellness Center Housing Development

Other: ________________________________________________________

Describe the Space: (E.g. employee kitchen) ____________________________

Please confirm the agency serves SNAP eligible participants: Confirmed

OHIO STATE UNIVERSITY EXTENSION

Document TitleSub head 1

OSUE SNAP-Ed Adult & Parent Curricula

Checklist: Minimum Requirements for Host Site class space

Please confirm/check:

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 for potential distracting activities (e.g. exercise class)

Host site has identified a committed site contact/point person for day of & during classes. Point person helps with set-up of class and greeting participants. Point person has an understanding of the course and the participants.

** 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.

Yes No

Please Check & provide description of resources host site to provide:

All Kitchen Equipment (bowls, plates, utensils, cooking equipment, pots/pans)

Some Equipment. Describe:_______________________________________

_______________________________________________________________________________________________________________________________________________________________________________________________________________________

OHIO STATE UNIVERSITY EXTENSION

Document TitleSub head 1

OSUE SNAP-Ed Adult & Parent Curricula

Resource Sharing: Please check resource to be provided by host site

Food: (In-Class Ingredients for Recipes / Take-Home Groceries.)

Describe: _________________________________________________

Shopper Class Assistant Culinary Volunteer Instructor

Volunteer to assist. Describe: ____________________________________

_______________________________________________________________

Childcare Transportation Participants

Was a grant secured to host OSUE SNAP-Ed Cooking Matters series at this site:

No Yes, Describe:_________________________________________

Is site providing funding? No Yes. Describe:_______________________

Site to provide other resources: Describe:___________________________