Licking County Local Food Week Participation Form

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The Licking County Local Food Council welcomes restaurants to participate in our upcoming Local Food Week, August 15-22, 2014. This project, based on a similar, successful project in Athens County, Ohio, publicizes local restaurants that serve at least one menu item with locally-sourced ingredients. The restaurants love it, the public loves it, and the farmers love it--win, win, win! It's easy to get started. Please complete the following form to be included in future advertising of participating restaurants. For questions, email: lickingcountylocalfood@gmail.com Thank you for your support of the local food economy!

Business Name *

Address & Zip *

Website

Contact person

Contact person email

Contact person phone

Business phone

Our business hours during Local Foods Week August 15-22

Our business will offer 30-Mile Meal dishes during Local Food Week for the following meal imes

Participating businesses will develop menu items and/or meals that primarily use locally-sourced ingredients. A 30 Mile Meal is a dining experience that includes as many local ingredients as possible. (Some ingredients- olive oil, spices, salt, etc. - are obviously not grown in this region but may be important elements of a meal and that’s fine.) During Local Food Week, we ask that you source any meats, cheeses, seasonal vegetables and fruits, salad greens, dairy, or eggs of your 30 Mile Meal menu item from local producers.

Breakfast

Lunch

Dinner

Happy Hour

Other:

My level of interest or commitment in participating in Local Food Week is:

(please select one)

All in! I am committed to making as many locally-sourced menu item options for Local Foods Week as possible

I would like to make at least one 30-Mile Meal entree or item available during Local Foods Week

I would like to start slow and introduce a few locally-produced ingredient items into my menu, but am not sure I am ready to commit to an entire locally-sourced entree

Not sure at this time

Other:

Clear selection

I am interested in offering the following menu options for Local Food Week (if known)

Local Food Sourcing Assistance

I would like assistance from the Licking County Local Food Council to source locally grown or processed ingredients

I currently have contracts or relationships to source locally

Unsure at this time

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