Adult & Parent Curriculum OHIO STATE UNIVERSITY EXTENSION OSU Extension SNAP-Ed Adult & Parent Curriculum Document Title Sub head 1 \ 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 Faith Based Institution Community Center Health Clinic/Center Wellness Center Housing Development Other:______________ NOKIDHUNGRY Describe the Space: ____________________________ Participants are SNAP eligible

Adult & Parent Curriculum OHIO STATE UNIVERSITY EXTENSION OSU Extension SNAP-Ed Adult & Parent Curriculum Document Title Sub head 1 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 from potentially distracting activities Host site has identified a committed site contact/ point person for during classes. Point person helps to set up class and greet participants. Point person has an understanding of needs of the class. ** 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 and provide description of resources host site to provide: All Kitchen Equipment (bowls, plates, utensils, cooking equipment) Some Equipment: ___________________________________________________ NOKIDHUNGRY

OHIO STATE UNIVERSITY EXTENSION OSU Extension SNAP-Ed Adult & Parent Curriculum Document Title Sub head 1 Resource Sharing: Please check resources to be provided by host site Food: (In-Class Ingredients for Recipes/ Take-Home Groceries) Describe: _________________________________________________ Shopper Class Assistant Voluntary Culinary Instructor Volunteer to Assist: Describe: _________________________________________________ Childcare Transportation Participants Was a grant secured to host OSUE SNAP-Ed Cooking Matter Series at the site? Yes Describe: _______________________________________________ No Is the site providing funding? Yes Describe: _______________________________________________ No Is the site providing other resources? Describe: _________________________________________________ NOKIDHUNGRY