Food Is History — Chef Participant Questionnaire — Cookbook & Filming Day
A collaboration of the James Hemings Society (NYC) and Cooks Who Care (Philly) · Filmed by iLovett Films. Filming Days: October 13–16, 2026 · Flatbush Central / Mangrove Tasting Kitchen, Brooklyn, NY. RSVP & recipe deadline: Friday, October 9, 2026 — time slots confirmed in order responses come in.
SECTION 1 — CONTACT & CREDIT INFO
Thank you for joining Food Is History. This short questionnaire confirms your time slot and filming-day logistics. You don't need to overthink your answers — short and honest is exactly what we're looking for.
What We Need From You By Friday, October 9: • Completed questionnaire • Copy of NYC Food Protection Certificate / Food Handler license and current ServSafe certification • Full written recipe with ingredients and step-by-step method emailed to LaToya or Maria • Optional photo of finished dish emailed with recipe
SECTION 1 — CONTACT & CREDIT INFO
Preferred Name / Pronunciation
*
Business, Brand, or Family Name for Credit
*
Social Media Handles and / or Website
*
Full Name
*
First Name
Middle Name
Last Name
Email
*
example@example.com
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Which days between October 13–16, 2026 could work?
*
Tue 10/13
Wed 10/14
Thu 10/15
Fri 10/16
Section 2 — Credentials & Compliance
Required for anyone cooking on site at the Mangrove Tasting Kitchen.
Upload NYC Food Protection Certificate or Food Handler License
Upload a File
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Choose a file
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of
SECTION 3 — SCHEDULING
Upload current ServSafe certification
Upload a File
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Choose a file
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of
Explain any exception, unavailable document, or alternative credential status
Recipe Submission
Recipe file
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of
SECTION 4 — YOUR DISH
Full written recipe
*
Other Notes
Which logistics apply to you?
Need parking
Need transit directions
Need wheelchair access
Need refrigeration for ingredients
Need assistance with equipment
Other
Please specify any other logistics or participant notes
Do you have a valid NYC Food Protection Certificate / Food Handler credential?
*
Yes
No
Upload NYC Food Protection Certificate / Food Handler Credential
Upload a File
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Choose a file
Cancel
of
Do you have a current ServSafe certification?
*
Yes
No
SECTION 5 — DIETARY, ALLERGEN & SAFETY NOTES
Upload current ServSafe certification
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of
Preferred Time of Day
*
Morning
Afternoon
No preference
SECTION 6 — MEDIA CONSENT & RELEASE
Can you arrive 30 minutes before your 1-hour slot and stay on schedule?
*
Yes
No
Will you join the kickoff activation at Lakay Lounge the evening the week begins?
*
Yes
No
Maybe
Section 7 — Media Consent & Participant Acknowledgment
Dish Name
*
In a sentence or two, what is this dish?
*
What ingredients and equipment will you bring? List anything you'll need the kitchen to provide.
*
Does your dish fit comfortably in the 15-minute demo window?
*
Yes
No
FINAL CONTACT INFO: LaToya Meaders, President, James Hemings Society — LMM@collectivefare.com · (929) 342-9246 Maria Campbell, Founder, Cooks Who Care — maria.anna.campbell@gmail.com · (484) 832-2065
If not, what can be prepped ahead of time?
Approximate Yield / Servings
Allergens
*
Milk/Dairy
Tree Nuts
Shellfish
Wheat/Gluten
Soy
Eggs
Other
Other
Dietary Descriptors
*
Vegan
Vegetarian
Halal
Kosher
Gluten-free
None
Anything else we should know — open flame, scheduling conflicts, safety notes, or other?
Electronic Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Questionnaire
Should be Empty: