Snack Program Form Snack Station Sign In Hello! Please fill out this form every time you visit a Snack Station. To better serve students, information from your response may be used by the UCSB AS Food Bank, Food Security & Basic Needs Taskforce, and UC IRAP to develop programming and metrics for public reporting on this service. PERM numbers will be used to assess unique versus repeat participants, but student names and contact information will not be shared beyond this service. We thank you for your cooperation!Your name(Required) First Last 6-7 alphanumeric perm number found on access card(Required) Perm Number UCSB email address (ucsb.edu)(Required) Which Snack Station location are you at? Campus, Advocacy, Resources, and Education (CARE) @ SRB 2nd floor (appointment only) Counseling and Psychological Services (CAPS) Educational Opportunity Program (EOP) @ SRB 2nd floor El Centro ICA Study @ Intercollegiate Athletics Department Food Security and Basic Needs Advising Center (SNAC) Health and Wellness / Women’s Center @ SRB 1st floor Media Center @ Annex Monarch Lounge Multicultural Center (MCC) ONDAS Student Center @ Kerr Hall 1120 Pardall Center Promise Scholars @ SRB 2nd floor Resource Center for Sexual and Gender Diversity (RCSGD) @ SRB 3rd floor Transfer Student Center (TSC) @ Kerr Hall 1120 Please note that this question is not required, but providing the Snack Station location you visited greatly helps inform programming decisions such as restocking frequency.How many snack items did you grab today? (1-3 items recommended)(Required) 1 2 3 4 or more If you are interested in long term food support, visit the AS Food Bank and the Food Security & Basic Needs Advising Center located in the UCSB University Center to learn more about campus and local resources. Please note that these Snack Stations are meant to alleviate short term needs.Optional: do you have any feedback for the program? Δ
