Organizational Request to Support Recommendation #20210122-3b (College Food Insecurity Grant Program)

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This form is intended for representatives of organizations, coalitions, student groups/clubs, city offices, and boards/commissions, to express their intent to sign onto a Statement of Support (included below), for recommendation #20210122-3b, passed unanimously by the College Student Commission on January 22nd, .

Variations of the above groups will be referred to as "organizations" for the remainder of this form.

The only people that will have access to the information provided on this form are the College Student Commissioners that are members of the Food Insecurity Working Group (under a quorum), and the City Staff Liaisons that supervise the Commission.

Email *

Please confirm that you have thoroughly read and reviewed recommendation #20210122-3b (accessible on the College Student Commission page on austin.gov) *

Yes

The statement of support is written as follows:

This document will include a written list of supporters following the statement.

We will not be incorporating logos, or marketing/branding material at this time.

What type of organization are your representing? *

Non-profit organization - 501(c)(3) and/or 501(c)(4)

For-profit organization/company

Coalition (group comprised of several organizations)

Student group or club

City Office or Department

Other:

FOR REPRESENTATIVES OF COALITIONS: Which organizations are members and/or represented by your coalition?

What organization are you representing? *

Is your organization located within Austin, TX city limits? *

Yes

No, but we are a part of the greater Austin area and/or located in surrounding communities.

Other:

What is your first and last name? (no personal information will be shared or used beyond contact purposes) *

What are your pronouns?

What is your title or position at your respective organization? *

What is your phone number?

Please provide any email address that is directly associated with your organization (EX. group.austin.tx@organization.com)

Do we have formal permission to include your organization as an official supporter of CSC recommendation #20210122-3b, to establish a College Food Insecurity grant program at the City of Austin? *

Yes, I have gotten explicit permission to list my organization as a supporter of this recommendation on the official Statement of Support document.

Not yet, please contact me with more information.

Other:

If you haven't already, sign the petition!

http://chng.it/shyJBmrx

A copy of your responses will be emailed to the address you provided.

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