2022 Fall Farm Fresh Challenge Attestation

1
Participant Attestation Form

Thank you for participating in the Texas Department of Agriculture (TDA) 2022 Fall Farm Fresh Challege. The Farm Fresh Challenge is a fun and engaging way for program operators to earn recognition for bringing local foods and agriculure-based learning activities to communities across Texas.

All participating CEs must complete and submit this form to be eligible to receive recognition. This form collects information about local products served, dollars spent on Texas products, details about educational actvities and community engagement methods. This information will help verify the completion of the below challenge parameters:

Eligible "Eat Local" products should be sourced locally - directly from a farmer, a farmers market, site or community garden, or through a distributor that works directly with local producers.

Educational activity examples include taste testing local foods, Meet the Farmer day, virtual or in person field trips to a farm or farmers market, virtual or in person garden-based learning activities, and educational lessons focused on local food and agricultural.

Be Social activities should include a social media post using either #FarmFreshTexas or #FarmFreshChallenge. If this is not an option at your facility explain how you engaged your community of parents and family members. Take a screen shot of the post on social media or take a picture of your flyer to complete this parameter. Submissions that are missing a picture will not be eligibile for the Best of the Bunch tier.
2
Please enter your information* This field is required.
CE Identification Number (CE ID)
Contracting Entity (CE) Name
Contact Name
Contact Email
Contact Phone Number
3
We look forward to learning how you met the Eat Local parameter of the challenge. Please answer the following questions about the local foods served during the challenge.
4
Please select which Eat Local parameter you completed: Best of the Bunch - 3 or more Texas foods (representing 3 different meal components) served each full week during the challenge. Prime Participant - 3 or more Texas foods (representing 3 different meal components) served anytime during the challenge.
Best of the BunchPrime Participant
5
Which locally-sourced meal component(s) did you serve during the challenge? Please check all that apply.
Milk
Meat/Meat Alternative
Fruit
Vegetable
Grain
6
What is the estimated total quantity and dollar amount of local milk served during the challenge?Amount of Units Purchased (Ex. 12 pounds)
Quantity
Units of purchase (Case, pounds, gallons, etc...)
Dollar Amount
7
How was this milk item(s) purchased?
Through a contracted distributor
Direct from a Texas farm or ranch
Grown in school garden
Other
8
If selected "Other" please explain.Explain how the item as purchased
9
What is the estimated total quantity and dollar amount of local grains served during the challenge?Amount of Units Purchased (Ex. 12 pounds)
Quantity
Units of purchase (Case, pounds, gallons, etc...)
Dollar Amount
10
How was the grain item(s) purchased?
Through a contracted distributor
Direct from a Texas farm or ranch
Grown in school garden
Other
11
If selected "Other" please explain.Explain how the item as purchased
12
What is the estimated total quantity and dollar amount of local fruit served during the challenge?Amount of Units Purchased (Ex. 12 pounds)
Quantity
Units of purchase (Case, pounds, gallons, etc...)
Dollar Amount
13
How was the fruit item(s) purchased?
Through a contracted distributor
Direct from a Texas farm or ranch
Grown in school garden
Other
14
If selected "Other" please explain.Explain how the item as purchased
15
What is the estimated total quantity and dollar amount of local vegetables served during the challenge?Amount of Units Purchased (Ex. 12 pounds)
Quantity
Units of purchase (Case, pounds, gallons, etc...)
Dollar Amount
16
How was the vegetable item(s) purchased?
Through a contracted distributor
Direct from a Texas farm or ranch
Grown in school garden
Other
17
If selected "Other" please explain.Explain how the item as purchased
18
What is the estimated total quantity and dollar amount of local meat/meat alternative served during the challenge?Amount of Units Purchased (Ex. 12 pounds)
Quantity
Units of purchase (Case, pounds, gallons, etc...)
Dollar Amount
19
How was the meat or meat alternative item(s) purchased?
Through a contracted distributor
Direct from a Texas farm or ranch
Grown in school garden
Other
20
If selected "Other" please explain.Explain how the item as purchased
21
Summarize how you met the Teach Local parameters of the Farm Fresh Challenge (i.e. garden-based learning activities, nutrition education, Harvest of the Month, providing videos for classroom instruction etc.). This should include an activity each week of the challenge.Activities do not need to be different each week to be eligible.
Week 1
Week 2
Week 3
Week 4
22
Summarize how you met the Be Social parameter of the Challenge (social media, newsletters, bulletin boards, etc.)
Huge
Large
Normal
Small
Ok
Ok
23
REQUIRED (name each file with the district name)- Attach photos/screenshots of social media, newsletter, or bulletin board posts you used to shared to complete the Be Social parameter (an image is required to be eligible for recognition).* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 20.4MB
Cancelof
24
TDA would like to share your Farm Fresh Challenge photos on SquareMeals as inspiration for other CEs and in newsletters to recognize your efforts. If you agree to share, please have the appropriate people fill out the photo release form(s) below.
25
By signing this form, I confirm the above information is complete and truthful.* This field is required.Name
Prefix
First Name
Last Name
26
TitleEx. Child Nutrition Director, etc...
27
Date
Date
Year
Month
Day
Should be Empty: