SNAP Outreach Event Request

Person Filling out Request:

First Name

Last Name

Email:

Phone Number

Best Time to Call

Organization Affiliated With:

Name of Event:

Location:

Date/Time

Target Population

Type of SNAP Outreach activity(s) requested (check all that apply and provide a narrative below):

Staffed Booth

Staffed Informational Table

Presentation

Informational Materials

Provide Topic Areas for Informational Materials Seeking:

Narrative:

Sample: Information about the availability, application process, eligibility requirements, benefits of SNAP, application assistance, answer general questions related to SNAP, assistance with change reporting, assistance with Interim reports, recertifications,

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SNAP Connect

Technology Adoption Days

Community Reminder

Interpretation Services Available

SNAP Outreach Event Request