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Let's Move Healthy offers a variety of healthy programs and alternatives for you and your community. Tell us a little bit about your organization to get started and see if you qualify.

Contact Information

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School / Organization Name
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Your Name / Point of Contact
*Required Field *Invalid E-mail Address
Contact E-mail Address
Contact Phone Number

Location and Organization Information

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Location Mailing Address
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Number of Students or Visitors
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Number of Staff Members
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Hours of Operation (i.e. "M-F, 7am - 3pm")
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Does your Organization operate year-round?
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Do you close for a period of longer than 2 weeks during a given year?
If so, when and for how long?
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What Extracurricular or After School Activities do you offer?

Placement and Current Vending Information

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Do you currently offer vending for students or vistors (disregard staff only areas)?
If so, what kind and how many? (i.e. "2 Drink Machines, 1 Snack")
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Will you be removing current vending machines, if any?
If so, how much notice would you need before delivery?
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Where would you place new Healthy Vending Machines? (i.e. Hallway, Cafeteria, Gym, etc.)
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Will there be stairs to navigate when installing new equipment?
If so, how many steps?
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Is there a freight elevator on site?
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Will the machine have its own dedicated power outlet?
**New machine NEEDS own power outlet due to frequency disturbances that occur with shared plugs.
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Will the machine be next to another machine, cooler or microwave?
**New machine CANNOT be placed next to water fountain or microwave due to frequency disturbances.

Healthy Food and Product Information

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Does your organization currently have a vending contract?
If so, what are the product / food restrictions?
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Does your organization follow nutrition guidelines from the state or district?
If so, please explain.
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Will students and visitors have access to vending machines all day?
If any access restrictions exist, please explain.
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Would you need a special product menu?
If yes, please explain.
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Besides vending, are there other food or beverage options available?
If so, what else is offered and when is it available?
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Are there any healthy options available?
If yes, what kind?

Applicant Verification

Just so we know you're a real person, please answer this question: 2 + 3 = ?

*One or more required fields were left blank. Please scroll up and revise your application.

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