July 2025 Membership Scholarship Application

BASIC INFO

Please provide the full Company/Organization Name (As you would like it to appear on TKC materials and website) *

What is the name of your teaching kitchen or program (if different from your organization name)?

Please select one of the following that best describes your organization type:

Academic: K-12 School

Academic: University

Community based organization

Corporate worksite

Culinary school

Healthcare: hospital

Healthcare: outpatient

Healthcare: Federally Qualified Health Center

Other

If you marked “Other”, please describe.

Organization Mailing Address Line 1 *

Organization Mailing Address Line 2

City *

State/Province *

Zip/Postal Code *

Country *

Organization Website (ideally with link to webpage that describes your teaching kitchen) *

FOUR ORGANIZATION REPRESENTATIVES

TKC Organization Membership allows four individuals to represent each member organization and to receive member benefits, which include being listed in the member directory, accessing the online portal, and attending virtual and in-person meetings.

Representative #1 (main contact): Name *

Representative #1 (main contact): Title *

Representative #1 (main contact): Email Address *

Representative #1 (main contact) Phone *

Representative #1 (main contact): Assistant Name and Email (if applicable): *

What type of credentials does Representative #1 have? Please select all that apply *

How does Representative #1 self-identify? (check all that apply) *

American Indian or Alaska Native

Asian

Black or African-American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

White

Prefer not to answer

Other

Representative #2 Name

Representative #2 Title

Representative #2 Email Address

Representative #2 Phone

What type of credentials does Representative #2 have? (select all that apply)

How does Representative #2 self-identify? (check all that apply)

American Indian or Alaska Native

Asian

Black or African-American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

White

Prefer not to answer

Other

Representative #3 Name

Representative #3 Title

Representative #3 Email Address

Representative #3 Phone

What type of credentials does Representative #3 have? (select all that apply)

How does Representative #3 self-identify? (check all that apply)

American Indian or Alaska Native

Asian

Black or African-American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

White

Prefer not to answer

Other

Representative #4 Name

Representative #4 Title

Representative #4 Email Address

Representative #4 Phone

What type of credentials does Representative #4 have? (select all that apply)

How does Representative #4 self-identify? (check all that apply)

American Indian or Alaska Native

Asian

Black or African-American

Hispanic or Latino

Native Hawaiian or other Pacific Islander

White

Prefer not to answer

Other

TEACHING KITCHEN TEAM

How many professionals are included in your core teaching kitchen team (i.e. how many individuals are involved in the most essential operations of the teaching kitchen)? *

How many professionals are included in your extended teaching kitchen team, meaning occasional instructors, volunteers, or researchers? *

What type of professional is your primary teaching kitchen lead? *

If you marked “Other”, please describe.

Which other types of professionals facilitate classes in your teaching kitchen? Mark all that apply. *

If you marked “Other”, please describe.

Please use this space to share any other information about your teaching kitchen team.

TEACHING KITCHEN FACILITIES & SETTINGS

How many teaching kitchen facilities does your organization currently operate? *

Which best describes your teaching kitchen facility(ies)? Mark all that apply. *

Borrowed

Built-in

Container/Pod

Mobile Cart

Pop-up

Virtual (organization teaching kitchen)

Virtual (home kitchen)

Other

If you marked “Other”, please name your type of teaching kitchen facility here.

If you have a planned teaching kitchen facility not yet in full operation, please share a brief summary of your plans and timeline here (and answer the remaining questions to the best of your ability given your current and/or planned offerings).

In what settings do you provide teaching kitchen programming? Mark all that apply. *

If you marked “Other”, please name the settings in which you provide teaching kitchen programming.

In what format(s) is/are your teaching kitchen program conducted: in-person, virtual, or a combination of both? *

In person ONLY

Virtual ONLY

Both in-person and virtual

TEACHING KITCHEN CURRICULA & PROGRAMMING

Does your teaching kitchen programming address specific health topics? If so, please select all that apply. *

If you marked “Other”, please name the other topic(s) your teaching kitchen programming addresses here.

Which key educational components are included in your teaching kitchen program(s)? Mark all that apply. *

Culinary skills and experiential teaching

Nutrition and food education

Physical activity

Mindfulness

Behavior change

Impact of food on the environment

Other

If you marked “Other”, please name the educational component(s) your teaching kitchen addresses here.

Which of the following do you formally work with in your teaching kitchen programs? Mark all that apply. *

Diabetes Prevention Program

Integrative Medicine

Lifestyle Medicine

Medical Nutrition Therapy

Shared Medical Appointments

E-consults

Other

N/A

If you marked “Other”, please name the aligned interventions you primarily work with here.

Please tell us about your current teaching kitchen curriculum/curricula: *

We currently use a curriculum that we purchased/license.

We are considering a curriculum for purchase/license.

We developed our own curriculum/curricula.

Other

Please describe what curriculum/curricula you use and why you chose it/them. *

Which of the following activities are participants involved in as part of your teaching kitchen program?

Watching cooking demonstrations

Watching lectures

Hands-on cooking

Tasting

Home assignments

Sharing a meal they prepared

Which of the following culinary skills are incorporated in your teaching kitchen classes? Mark all that apply.

Kitchen set up and safety

Food sanitation and safety

Basic cooking / food prep skills

Healthy cooking techniques

Meal planning and food shopping strategies

Meal budgeting

Guided grocery store and/or farmer's market tours

Are there any other major topics within culinary skills that you cover? Please describe.

Which of the following nutrition & health topics are incorporated in your teaching kitchen classes?

General guidelines for healthy dietary patterns

Recommendations for specific foods/nutrients

Disease-specific recommendations

Are there any other major topics within nutrition & health that you cover? Please describe.

Which of the following environmental sustainability topics are incorporated in your teaching kitchen classes?

Environmental impact of food production, procurement and/or dietary patterns

Local and sustainable sourcing

Waste reduction and composting

Food labeling (non-GMO, organic, cage-free, etc)

Energy-efficient cooking strategies

Water conservation

Are there any other major topics within environmental sustainability that you cover? Please describe.

Which of the following physical activity topics are incorporated in your teaching kitchen classes?

General guidelines for increased physical activity

Guided exercises / activity bursts during class

Are there any other major topics within physical activity that you cover? Please describe.

Which of the following mindfulness topics are incorporated in your teaching kitchen classes?

Definition and benefits of mindfulness as applied to eating, cooking, exercising, sleep, etc.

Guided mindfulness exercises during class

Are there any other major topics within mindfulness that you cover? Please describe.

Which of the following health coaching and behavior change topics are incorporated in your teaching kitchen classes?

Individual health coaching with program participants

Facilitate group discussion

Follow-up sessions after intervention period

Are there any other major topics within health coaching & behavior change that you cover? Please describe.

POPULATIONS

What populations do you work with in your teaching kitchen? Mark all that apply. *

If you marked “Other”, please name the other population(s) you work with here.

In what language(s) do you teach classes in your teaching kitchen? Select all that apply. *

English

Chinese

French

Spanish

Tagalog

Vietnamese

Haitian-Creole

Other

If you selected “Other”, please state other languages in which your teaching classes are conducted.

What primary language(s) other than English do your participants speak? *

DATA

How frequently does your organization engage in program impact evaluation activities? *

Never

Rarely

Occasionally

Frequently

What type of data, if any, do you collect about your participants? Mark all that apply.

Pre/post self-reported data on knowledge, skills

Feedback on classes and recipes

General descriptive data (age, gender, race)

Medical history (e.g., diabetes, hypertension, heart disease)

Body measurements (height, weight)

Biometric data (lipid panel, blood sugar)

We do not collect data at this time

Other

If you selected “Other”, please name the type of data you collect.

FUNDING

Which sources contribute to funding your teaching kitchen? Mark all that apply. *

If you marked “Other”, please state other funding sources for your teaching kitchen here.

What approximate level of up-front investment was made in your kitchen facility/facilities? Please give your best guess. *

Under $1,000

$1,000-$10,000

$10,000-$50,000

$50,000-$100,000

$100,000-$200,000

$200,000-$300,000

$300,000-$400,000

$400,000-$500,000

Over $500,000

On an annual basis, approximately how much does it cost to run your teaching kitchen and associated programs (including staff, programming, facilities upkeep etc.). Please give your best guess. *

Under $5,000

$5,000- $20,000

$20,000- $35,000

$35,000-$50,000

Over $50,000

What category constitutes the highest cost involved in running your teaching kitchen program? *

Staff salaries

Programming (curriculum development, purchase)

Incremental class supplies (food, disposable supplies, printed materials, etc.)

Ongoing facilities investments and maintenance

Other

If you marked “Other”, please name the category here.

Have you found any strategies to be particularly effective in securing funding for your teaching kitchen program? If so, please describe. *

REACH & IMPACT

How many unique participants attended your teaching kitchen programs in person in 2024? If you don’t have an exact number, please give us your best estimate based on the average number of classes per month and average class size.

How many unique participants attended your teaching kitchen programs virtually in 2024? If you don’t have an exact number, please give us your best estimate based on the average number of classes per month and average class size.

Please share links to research or practice papers your teaching kitchen has published over the last year in peer-reviewed journals (if any).

Please share links to press over the last year about your teaching kitchen (if any).

Please share conferences or other venues where your teaching kitchen program was presented in the last year (if any).

Please share your primary social media handles (if applicable).

THANK YOU FOR COMPLETING THIS PORTION OF THE APPLICATION!

Please complete your application by sending the required materials (described at the top of the form) to membership@teachingkitchens.org by May 9, 2025.