GREAT Affiliate Interest Survey
Answers marked with a * are required.
 
1.

Name

*
 
 
 
2. Address *
 
 
 
3. City, State Zip
*
 
 
 
4. Phone *
 
 
 
5. Email *
 
 
 
6.

Why are you passionate about gluten-free food?

*
 
 
 
7.

What are you interested in doing with NFCA?

*
 
 
 
8.

Are you connected to a local support group? If yes, which one?

*
 
 
 
9.

How much time are you looking to spend with us?

*



      
 
 
 
10.

Are you able to lead a new effort or are you looking for a defined task within an existing project?

*
 
 
 
11. What role best suits your interests in working with NFCA? *








      
 
 
 
12. What do you think is the most pressing issue for the celiac and gluten-free community in your area?
*