Cooking Matters Satellite Partner Course/Tour Order Form

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1. Satellite Partner Organization*
2. Course/Tour Coordinator Name*
3. Email Address*
4. Phone*
5. Physical Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Where you would like the program materials sent
6. Course Dates and Times
Date Time
7. Program materials are being ordered for?*
- Cooking Matters 6-Week Courses (CM)
- Cooking Matters at the Store (CMATS)
8. Curriculum needed:
- Cooking Matters for Adults
- Cooking Matters for Families
- Cooking Matters for Kids
- Cooking Matters for Teens
- Cooking Matters EXTRA Diabetes
- Cooking Matters for Parents
- Cooking Matters for Child Care Professionals
- Cooking Matters at the Store
- Cooking Matters at the Store for WIC
9. Do you need this in Curriculum in English or Spanish?
- English
- Spanish
- Both
10. How many instructor guides do you need for this course?
Please take into consideration any program materials you have on hand
11. How many graduates do you expect from this course?
12. Have you completed background checks on the volunteers that will be working with Children and or teens?
- Yes
- No
13. Please indicate any additional comments about this course

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