Created for Ashley Heller by Anthony Harvey on 09/25/2023
2023 Team Nutrition Training Completion Form
Please complete this form after you have completed all courses within Moodle.
Participant Information
Participant Full Name
*
First Name
Last Name
Race/ethnicity (check all that apply):
*
American Indian or Alaskan Native
Asian or Asian American
Hispanic or Latino/a
Middle Eastern or North African
Pacific Islander
White or European
Prefer not to say
Participant Title
*
Please Select
Director
Assistant Director
Dietitian
Manager
Cafeteria Worker
Email
*
Confirmation Email
example@example.com
Phone Number
*
Sponsor Number
*
Sponsor number found in CNPWeb upper right-hand corner
Site Number
*
Found on Applications tab in CNPWeb. If a director, please type N/A.
Name of School
*
As listed in CNPWeb. If a director, please type your corporation name.
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Supervisor Full Name
*
First Name
Last Name
Supervisor Email
*
Confirmation Email
example@example.com
Site Information
Site or Sponsor Enrollment
*
For directors, please enter your sponsor enrollment numbers. For all other staff, please enter your specific site enrollment.
Site or Sponsor Free/Reduced Price Lunch %
*
For directors, please enter your sponsor percentage numbers. For all other staff, please enter your specific site's number.
What is the biggest challenge or obstacle your school experiences with implementing the meal pattern?
What is the biggest challenge or obstacle you face with training in regards to the School Nutrition Programs?
Certification
I certify that I have completed all courses in Moodle and that the above information to the best of my knowledge and belief is true and correct in all respects and that there are records available to support the information I have submitted.
*
Yes
No
Submit
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