Fresh Bucks Waitlist Application11 of 12

Note: Fields marked with a * are required.

During the past month, how often did you eat fruit?

Include fresh, frozen, or canned fruit. Do not include juices.

During the past month, how often did you eat a green leafy or lettuce salad, with or without other vegetables?

During the past month, how often did you eat any kind of fried potatoes, including French fries, home fries, or hash brown potatoes?

During the past month, how often did you eat any other kind of potatoes, such as baked, boiled, mashed potatoes, sweet potatoes, or potato salad?

During the past month, not including what you just told us about (green salads, potatoes), how often did you eat other vegetables?