Food Heartland Champion Application Form

Food Heartland Champion Application Form
Contact Information:
Name*

First NameLast Name
Business or Farm Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Post Code
Phone Number*
Email*
example@example.com
Eligibility
Are you based within the Armagh City, Banbridge and Craigavon Borough area?*

YesNo
Which Food Heartland Champion categories are you applying for?*

Young Farming ChampionWomen in Farming ChampionFarm Safety ChampionEnvironmental ChampionMental Health ChampionFood and Drink Producer ChampionChef/ Hospitality ChampionMarkets Champion
How long have you been working in your selected area?*
Experience and Alignment
How would you contribute to the Food Heartland Community? [agriculture/agrifood/rural]*
How do you align with the Food Heartland core values of Quality, Local, and Sustainable?*
Would you be willing to speak at events to help share your knowledge and inspire others? Is this something you have experience of doing already?*
Vision and Passion
Within your chosen Champion category, what changes would you like to see to improve it?*
In your chosen Champion category, what are the main challenges and opportunities?*
Commitment
If selected, would you be willing to represent the Food Heartland area on television, radio, social media, in the press, etc.?*

YesNo
Do you hold membership or any office in a political party which may cause you to be seen as not politically neutral? *

YesNo
Thank you for taking the time to complete this form. Please use the space below for any information you feel is important to share with us.
Confirms that neither the applicant nor anyone associated with the business organisation or management has been convicted of any criminal offence not considered to be “spent” under the Rehabilitation of Offenders (NI) Order 1978 which has not already been disclosed*

Yes
I understand that in addition to the standard pre-employment checks this position may also be subject to receipt of a satisfactory Basic AccessNI check*

Yes
We process your personal data in accordance with our legal obligations under the Data Protection Act 2018 (DPA) and the UK General Data Protection Regulation (UK GDPR).
Should be Empty:

Food Heartland Champion Application Form

Contact Information:

Eligibility

Experience and Alignment

Vision and Passion

Commitment