Organizational Membership Application
Thank you for your interest in the Adirondack Food System Network! We are pleased that you and your organization are willing to join us as we collaborate, connect, and advocate for a more resilient, just, and equitable food system in the North County and beyond! As you consider joining us, we would appreciate an information that you can provide regarding your operations and programs.
Name
*
First Name
Last Name
Your Email
*
example@example.com
Are you authorized to join on behalf of your organization?
*
Yes
No
I am filling this out on behalf of someone who will be regularly attending
Other
Contact Phone
Please enter a valid phone number.
Organizational Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Individual (if different) who will be attending regular meetings
First Name
Last Name
Email
example@example.com
Name
First Name
Last Name
Email
example@example.com
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Organizational Information
Tell us more about your organization.
Website:
*
Which counties do you serve? (Click all that apply)
*
Clinton
Essex
Franklin
Fulton
Hamilton
Herkimer
Lewis
Oneida
St. Lawrence
Saratoga
Warren
Washington
What sector(s) best defines your work?
*
Economic and regional development
Funder
Emergency Food (Food pantry, food shelf, backpack)
Farm to Institution (Farm to School, Farm to Hospital)
Food and healthcare (Food as Medicine, produce prescription)
Food hub and/or distributor
Farmer or producer
Retailer or market
Other
What services do you provide to your community?
How did you become aware of AFSN?
What excites you about joining the Network?
What do you bring to this coalition?
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Questions, Concerns and Next Steps
Following the submission of your application, the information will be reviewed by our membership committee in a timely manner. If successful, you will be asked to sign a organizational letter of commitment. Questions or concerns can be sent directly to Josh Stephani, Director of AFSN at josh@adkfoodsystem.org.
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