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First Name

Last Name

Email Address

Organization Name

Job Title

Sector of Work (Where the majority of your organization's funding comes from)AgricultureCommercial MarketingCommunity DesignEducationFood industryGovernmentMediaPublic health and healthcarePublic safetyOtherSector of Work - other details

Specific organization typeAgricultural organization (includes farmers markets)Chefs/culinary instituteCity and regional planning groupEarly care and education facility (includes child care centers and day care homes as well as Head Start, preschool, and pre‐kindergarten programs)Faith-based groupFood bank/food pantryFood store (convenience stores, grocery stores, supermarkets, etc.)Foundations/philanthropy organizations/nonprofitsGovernment program agency (Federal, State, local)Hospitals/healthcare organizations (includes health insurance companies)Human servicesIndian Tribal OrganizationLabor/workforce development groupMedia/advertising groupParks and recreation centerPublic health organizationRestaurantSchool (preschools, K-12, elementary, middle, and high)School (colleges and universities)Transportation groupOtherSector of Work - other details

Where is your organization geographically located? Please select each district county area that you serve.District 1: Lake, Porter, LaPorte, Newton, and JasperDistrict 2: Starke, Pulaski, Fulton, Marshall, St. Joseph, Elkhart, and KosciuskoDistrict 3: Miami, Wabash, Huntington, Wells, Adams, Allen, Whitley, Dekalb, Noble, Steuben, LaGrangeDistrict 4: Warren, Fountain, Montgomery, Clinton, Tippecanoe, Benton, White, Carroll, and CassDistrict 5: Morgan, Johnson, Shelby, Hendricks Marion, Hancock, Boone, and HamiltonDistrict 6: Rush, Fayette, Union, Henry, Wayne, Madison, Delaware, Randolph, Tipton, Howard, Grant, Blackford, and JayDistrict 7: Sullivan, Greene, Vigo, Clay, Owen, Vermillion, Parke, and PutnamDistrict 8: Orange, Washington, Lawrence, Jackson, Monroe, Brown, and BartholomewDistrict 9: Harrison, Floyd, Clark, Scott, Jefferson, Switzerland, Ohio, Jennings, Ripley, Dearborn, Decatur, and FranklinDistrict 10: Posey, Vanderburgh, Warrick, Spencer, Perry, Gibson, Pike, Dubois, Crawford, Knox, Daviess, and Martin

Please select what information you would like to receive from SNAC The SNAC monthly newsletter and related announcementsQuarterly meeting invitations and announcementsA 30-minute networking meeting with the SNAC team

How did you hear about SNAC? SNAC websiteEmail invitationSNAC newsletterWord of mouth/CoworkerNetworking eventOtherHow did you hear about SNAC - other details