Local Food Matters Stakeholder Interest Form

Local Food Matters Stakeholder Interest Form

Public engagement campaign stakeholder interest form for Dec 2026 – Feb 2027. Answer the questions that apply to you.
Basic Information
Full name

First NameMiddle NameLast Name
Email address
example@example.com
Phone number
Please enter a valid phone number.Format: (000) 000-0000.
Organization or affiliation
Preferred contact method
Your Connection to the Local Food System
Which of the following best describes your connection to the local food system?

Other
Which roles do you currently play in the local food system?

Other
Please describe your connection to the local food system.
How long have you been involved in the local food system?
Your Experience With Local Food Challenges
Which local food challenges have you personally experienced?

Other
How severe have these challenges been for you or your household?

1

2

3

4

5

6

7

8

9

10

1 is Minor, 10 is Severe
Please briefly describe the local food challenges you have experienced.
When did these challenges most affect you? (Start Date)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
When did these challenges most affect you? (End Date, if applicable)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Availability & Willingness to Participate
When are you generally available to participate?

Other
How willing are you to participate?
What participation formats are you open to?

Other
Please share any scheduling constraints or participation preferences we should consider.
Sector Representation Priorities
Which sectors should be represented in the Local Food Matters stakeholder group?

Other
Which perspectives should be prioritized in the discussion?

Other
Which stakeholder group should be prioritized first?

Other
Please share any additional stakeholder groups, sectors, or viewpoints that should be represented or prioritized.
Motivation & Fit
Why do you want to participate in the Local Food Matters campaign?
How does your background, perspective, or experience fit the campaign’s needs?
Which of the following best describes your motivation for joining?
Preferred participation window
Optional: Ongoing Interest
Would you like to be contacted about future local food engagement opportunities?
Which topics would you be interested in for future follow-up?

Other
If contacted for a follow-up between Sept 2026 and Dec 2027, what is your preferred timing?
Should be Empty:

Local Food Matters Stakeholder Interest Form

Basic Information

Your Connection to the Local Food System

Your Experience With Local Food Challenges

Availability & Willingness to Participate

Sector Representation Priorities

Motivation & Fit

Optional: Ongoing Interest