Success Story Template
Submit with your implementation plan checklist and application for recognition to
Success stories should be about three paragraphs and answer the questions below.
Questions for success story
- Which of the Healthy Nutrition Guidelines did you implement?
- How did you implement them?
- What changes did you see? (With your customers, employees, population served, etc.)
- What activities worked well?
- What impact did they have?
- How will you apply what you learned from this last year?
- What recommendations do you have for other agencies or organizations implementing the Healthy Nutrition Guidelines?
Write your story here:
Additional questions
Are you including any of the following to accompany your story? (Check all that apply).
Quote from partner or participant Video Other
Samples of promotional materials Photo(s)
I give the Department of Health permission to use this success story and any additional materials submitted.
Name: Position:
Signature: Date: