Foodlink Career Fellowship Nomination Form

Foodlink Career Fellowship Nomination Form

Please fill out this form to nominate a candidate for the program. If you have any questions, contact us at fcfellowship@foodlinkny.org
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Nominee Information

Information about the person you're nominating.
Nominee's Full Name

First NameLast Name
Nominee's Email Address
example@example.com
Nominee's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Nominee's Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Nominator Information

Information about you.
Name

First NameLast Name
Agency/Organization/Affiliation
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Office Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Cellphone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
How long have you known the nominee and what is the nature of your relationship?
Briefly describe why you believe this fellowship is a good fit for the nominee.
In what capacity do you support/advocate for the nominee?
Does the nominee collaborate with care management, coordinators or a therapeutic team?
The Foodlink Career Fellowship requires that nominees are able to meet the following basic requirements

Foodlink Career Fellows must (be):
- At least 18 years of age
- Able to maintain a daily schedule generally between the hours of 8 am to 5 pm, Monday-Friday
- Eligible to work in the United States
- Drug free
- Live in a stable housing environment
- Home for at least one month after incarceration, and clear of any arrest warrants
- Have a current physical exam (within a year of the date of application)
- Able to see well enough to read at 2.5 feet with reasonable accommodations
- Able to stand for a minimum of 8 hours with two 10-minute breaks and be able to lift 50 pounds with reasonable accommodations
- Able to hear in an environment with background noise from a distance of 20 feet with reasonable accommodations
- Able to complete a literacy and math assessment in English
- Able to read, speak, and comprehend English in a fast-paced environment
- Able to successfully complete the hands-on, pre-training shadow and evaluation
Please detail any challenges the nominee may have to meeting these requirements:
To your knowledge, does the nominee require any educational or workplace accommodations?
Describe any educational or workplace accommodations required by the nominee.
Additional Enclosures (Check all that apply)

Other
Additional Enclosures Upload

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The Foodlink Career Fellowship is a training program, and will not take the place of any social service agency the nominee is/will be utilizing.
Are you willing to maintain a collaborative relationship (maintain an open line of communication, attend meetings, etc.) with Foodlink staff to promote the overall well-being of the nominee and support them in meeting their career goals?
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Foodlink Career Fellowship Nomination Form

Nominee Information

Nominator Information

The Foodlink Career Fellowship is a training program, and will not take the place of any social service agency the nominee is/will be utilizing.