Nutrition Literacy and Community Resource Workshop Registration Form

In conjunction with the Niagara County Department of Health, on Thursday July 25, 2024, DFOWW Incorporated will host a free nutrition literacy and community resource workshop from 10am -3pm, at Niagara Falls High School 4455 Porter Road, Niagara Falls, New York 14305.

The purpose of this event is to provide nutrition literacy education to the community and to connect individuals, families and children with services, programs and community based available resources.

Individuals who do not have access to the online registration form may register by telephone by contacting our main office at (678) 977-9703 Monday-Friday from 11am – 4pm.

Date: (YYYY-MM-DD)

Full Legal Name

Phone Number

Home Address/Current Residence

City

State

Zip/Postal Code

Please Select Gender

Race and Ethnicity

Are you a U.S. Citizen? You must be a U.S. Citizen to register

Are there any children living in your household under the age of 17?

Will any children be attending the workshop with you?

If you answered yes to the above question, please list the children’s age and gender who will be attending with you below:

How did you hear about this free workshop?

Do you need any accommodations to attend this event?

If you answered yes to the above question, what accommodations will you need?

Privacy Policy:

Your privacy is critically important to us, and we secure your privacy by adhering to the following:
We store personal information only as long as we have a reason to keep it.
We share your personal information with Federal, State, and local governmental agencies for impact reporting purposes. In addition, as part of their oversight role and fiduciary duties, existing members of the board of directors may review personal information we collect.
All personal information is stored in our internal, secure company database. Only trusted, high-level senior staff and members of the DFOWW Incorporated board of directors can access such privileged and sensitive information.

I understand that my image may be copied, exhibited, published, or distributed for marketing purposes of DFOWW Incorporated. All attendees will be required to complete a photo release form which will be provided upon entry at the event.

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