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I am interested in this learning opportunity primarily because I am a: Community Based/Nonprofit Organization Community Member Government Official/Staff Health Professional Parent School Professional-Administrator School Professional-Board Member School Professional-Food Service School Professional-Health Teacher School Professional-Higher Ed School Professional-Nurse/Health Aid School Professional-P.E. Teacher School Professional-Teacher School Professional-Other Student None of the Above

I am the parent of school-aged child Yes No

Interest Area(s) Food: School Breakfast & Lunch Food: Other School Food Hunger Nutrition Education Physical Activity at School Physical Education hold down the control key to choose 2 or more

Primarily, how would you be willing to support our mission? Donate to school wellness programs Represent AFHK on a school wellness team Share school wellness info at a school Volunteer at wellness events at a school I'm not willing to get involved now hold down the control key to choose 2 or more

How did you first hear about Action for Healthy Kids? Advertisement Article or News Story (newspaper, online, tv, etc.) Community or Other Non-Profit Organization Email Friend or Family Member Internet Search Newsletter Parents for Healthy Kids School Social Media Other

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