LIVE NM Food Pathways Quick Assessment

Quick Assessment
Initial Screening Section
Date*

MonthDayYear
Date
Full Name of Key Point of Contact*

First NameLast Name
Secondary Point of Contact (if applicable)

First NameLast Name
Business or Organization Name*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Business or Organization Structure (Choose one):*
Business or Organization Structure Other (please specify):*
- Funding (loans, grants, etc.)Business development/mentorshipMarketing/branding supportWorkforce training/developmentFinancial management
- Disclaimer
  
  These questions help us better understand the communities we serve and are required as part of our reporting for the USDA Healthy Food Financing Initiative (HFFI), which funds New Mexico Food Pathways. Your responses will not impact the consideration of your application in any way.
  
  The information you share helps us paint a clearer, more accurate picture of who we are currently reaching and where we can strengthen outreach and support through our programs. This allows us to demonstrate impact, ensure accountability for public funding, and improve how we serve New Mexico communities.
  
  Please self-identify as applicable. All responses remain anonymous and are reported only in aggregate. Your input is invaluable and deeply appreciated.
- Women-ownedVeteran-ownedMinority-ownedRural-basedLGBTQ+-ownedDisability-ownedSocially disadvantaged groupNon-native English speaking or InternationalNone of the above
- MaleFemaleChoose not to answerOther
- YesNoChoose not to answer
- Black or African AmericanIndigenous (please specify your tribe below):WhiteOther ethnicities (please specify below):Choose not to answer
- Please specify your tribe or other ethnicities
- YesNo
- Eligibility Instructions for Applicants
  
  We will determine your eligibility for this program based on the information you provide in the following sections. Please review the guidelines below and provide accurate responses.
  
  Eligibility Overview
  To qualify for this program, your project or business must meet certain criteria related to:
  1. ✅ Expand or maintain access to fresh, staple, or perishable foods in underserved areas.
  2. ✅ Be a for-profit food retailer (e.g., grocery store, mobile market, food co-op) that serves an underserved area and accepts SNAP benefits.
  3. ✅ Be a for-profit food enterprise (e.g., food hub, commerical kitchen, food aggregator) that supports food retail in underserved areas.
  📌 If you’re unsure, continue filling out the form, we’ll follow up with you!
- Business or Organization Location: Provide the full address where your business or organization operates. If you serve multiple locations, include your primary location and indicate the service area.*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- How does your Business or Organization meet the eligibility criteria?*
  Describe what your business does and who it serves (e.g., low-income, tribal, rural communities).
- Instructions: Determine Your Project Type
  Please select the project type that best describes your business or organization. Carefully review the definitions below to ensure you select the correct category:
  - For-Proft Food Retail:
    
    Grocery stores
    
    Mobile markets
    
    Food cooperatives
    
    Farmers' markets
  - For-Proft Food Enterprises:
    
    Food hubs
    
    Food producers, distributors, processors, and manufacturers
    
    Commercial kitchens and food business incubators
- Food RetailFood Enterprise
- YesNoIn the process of applyingPlanning to apply within the next 30 daysNot planning to apply
- Not startedApplication submittedSite visit completedApprovedDeniedOther
- DairyProduce: Fruits and VegetablesProtein: Meat, Poultry, Eggs, and FishGrains: Breads and Cereals
- YesNo
- Partnering with local/regional producersInvesting in cold storage or processing infrastructureProviding workforce development or job trainingSupporting sustainability or climate-adaptive practicesOther
- Food Producer (farmer, rancher, grower)Food DistributorFood ProcessorFood ManufacturerFood HubCommercial Kitchen / Shared KitchenFood Business IncubatorOther
- YesNoNot Sure
- YesNo
- YesNoIn the process of applyingPlanning to apply within the next 30 daysNot planning to apply
- Not startedApplication submittedSite vist completedApprovedDeniedOther
- Yes, within the next 12 monthsMaybe, we’re exploring optionsNo
- DairyProduce: Fruits and VegetablesProtein: Meat, Poultry, Eggs and FishGrains: Breads and Cereals
- YesNo
- YesNoNot Sure
- Partnering with multiple local/regional producers or distributorsExpanding cold storage, transportation, or processing capacitySupporting sustainability or climate-adaptive practicesProviding training or workforce developmentEnhancing infrastructure that supports access to perishable/staple foodsNone of the above
- What phase best describes your business or organization?*
- What Happens Next
  Once you submit your application, we will review your information and determine your eligibility. If we require additional information, we will contact you using the details you provide. Please ensure your contact information is accurate.
  
  If you have questions or concerns about eligibility requirements, feel free to contact us julie@vidamejorcapital.com
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Quick Assessment

Initial Screening Section