Membership Application

Last Name:

Email:

Street Address:

City:

State/Province:

Zip:

Heard about BFC from:
–None– Print advertisement Facebook Twitter Blogs Email Friend or Colleague

Opt-out of Email Communications?

Do not call.

What is your Preferred method of contact?

Phone E-mail Text Social Media Mail Other

Other:

—Please Fill Out the remaining Question if you wish to become a BFC Volunteer, or you can to complete your membership (the recommended donation amount is $25) —

Skills:

Communications Media Relations Web Programming/Development Fundraising Graphic Design Event Support & Planning Community Organizing Data Entry Tabling and Outreach Administrative Support Child Care (PSFC training needed) Other

Skills Other:

Park Slope Food Co-op Member? (Volunteering with the BFC counts towards FTOP):
–None– Yes No

I am most passionate about (select all that apply):

Organic Food Worker's Rights Fracking School Food Buying Local Urban Farming Racism in the Food System Food Access Hunger Climate Change Other

If you are interested in the following topics, please order them (1 = most interesting, 5=less interesting)

Organic Food:
–None– 1 2 3 4 5

Worker's Rights:
–None– 1 2 3 4 5

Fracking:
–None– 1 2 3 4 5

School Food:
–None– 1 2 3 4 5

Buying Local:
–None– 1 2 3 4 5

Urban Farming:
–None– 1 2 3 4 5

Racism in Food System:
–None– 1 2 3 4 5

Food Access:
–None– 1 2 3 4 5

Hunger:
–None– 1 2 3 4 5

Climate Change:
–None– 1 2 3 4 5

Which has impact?:
–None– Donating to a Cause Online Activism (petitions) Social Media Actions Picketing and Rallying Tabling at Events Mailing a Petition

— Please your responses… you wil be taken to the donation page to complete your membership (the recommended donation amount is $25) —