Note: please review the Cooking Matters by Share Our Strength Waiver and Release – you will be asked to acknowledge that you have read it at the bottom of this form. 2021 Cooking Matters Virtual Class Registration "*" indicates required fields Name* First Last Title Organization Address* Mailing Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone Number*Participant QuestionnaireThis is a Cooking Matters class. How many Cooking Matters lessons have you attended? This is my first Cooking Matters Lesson I have attended more than 1 Cooking Matters lessone I don't know Have you or anyone in your household participated in any of the following programs in the last year? (Check all that Apply) WIC SNAP (formerly food stamps) Free or reduced price school breakfast, lunch, or supper Free school meals Head Start Food Pantry Medicaid Food Distribution Program on Indian Reservations Did not participate in any of these programs What is your age? Under 18 18-29 30-39 40-49 50-59 65 or Above What is your sex? Male Female What is your race? (check all that apply) White Black or African American Asian Native Hawaiian or Pacific Islander American Indian or Alaska Native Other (please specify) Other Are you Hispanic or Latino? Yes No Cooking Matters RegistrationCooking Matters goes Virtual! Join us for a virtual cooking class, Cooking Matters at Home (Courtesy of Share Our Strength?). These 60-minute classes will help you learn how to prepare healthy, budget-friendly meals for your family! Dates*Choose the class you wish to attend: Wednesday July 28 at 5:30 pm Wednesday August 25 at 5:30 pm Wednesday September 9th at 5:30 pm Consent* I have read the Cooking Matters by Share Our Strength Waiver and ReleasePlease acknowledge that you have read and agree to the release form. The link is at the top of this page.Message (optional)PhoneThis field is for validation purposes and should be left unchanged.