Application Culinary Choice application Four short steps. You can save your progress and come back to finish. ← Back to program details "*" indicates required fields Step 1 of 4 25% CompanyThis field is for validation purposes and should be left unchanged.Personal InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Number*Cell NumberEmail* Enter Email Confirm Email Date of Birth* School & Personal MotivationWhat ward do you live in?*What is your GPA?*What school do you attend?*What part of this program do you think you will enjoy most?* Cooking Nutrition Education Agriculture Select AllUpload a 3-minute videoMax. file size: 2 GB. As part of your application, we want to get to know you and learn about your passion for food and healthy eating. In a 3-minute video, introduce yourself by sharing your name, school, and what excites you about cooking. Next, tell us about your favorite recipe—what dish do you love to make or eat, and why is it special to you? Finally, explain how healthy eating impacts your daily life, whether it helps you stay energized, focused, or feel your best. Be creative, have fun, and let your personality shine! No professional equipment is needed—just record your video on your phone and submit it with your application. We can’t wait to see your creativity in action! Health Insurance InformationYou may have to ask your parents for help Are you a MedStar Family Choice DC member?* Yes No If so, what is your member's number?Which insurance are you an enrollee of:Amerihealth Caritas DCAmerigroup DCHealth Services for Children with Special NeedsCommercial InsuranceCommercial Insurance: If so, please tell us which one (Carefirst, Blue Cross Blue Shields, United Healthcare, etc.) Culinary Program Consent Agreement & WaiverConsent*I agree to the privacy policy.I do not agree to the privacy policy.I hereby acknowledge and agree to participate in the Culinary Program organized by Food Jonezi Friendz. I understand that this program involves hands-on culinary activities, including the use of kitchen equipment, handling food, and working in a collaborative environment. By signing this agreement, I confirm that: I voluntarily participate in the Culinary Program and agree to adhere to all program rules, safety guidelines, and instructions provided by instructors and staff. I understand that the program involves potential risks, including but not limited to cuts, burns, and exposure to food allergens. I will follow all safety procedures and notify the program staff of any known allergies or health concerns. I grant permission for the program to use my name, photos, and videos taken during activities for promotional, educational, and program-related purposes. I understand that any misconduct or failure to follow program guidelines may result in my dismissal from the program. Parental/Guardian Consent (If Under 18) As the parent/legal guardian, I grant permission for my child to participate in the Culinary Program. I acknowledge the risks involved and release Food Jonezi Friendz, its staff, volunteers, and affiliates from any liability related to my child's participation. I further agree that: I will provide any necessary medical or allergy information relevant to my child’s participation. I understand that I must complete and submit a signed waiver before my child can participate. Waiver Submission All participants (or their legal guardians) must click above that they agree to the official waiver form before the program start date.CAPTCHA