Standard Mobile Pantry Report Form
ONLY SUBMIT IF YOU ARE PARTICIPATING IN THE MOBILE PANTRY TRUCK OR PRODUCE DROP/EXPRESS PROGRAM WITH NTFB.
Agency Name & Number
Please type Agency's name as listed on program/product invoices.
*Please type or choose the distribution date.
Date Picker Icon
Week of the month
Total number of households served
Please enter the number of unduplicated households served during report month
Total number of clients served
Please enter the number of total CLIENTS served based on household data gathered
Examples: Program Contact, Dept Manager/Director,
# of Volunteers
Including yourself, how many people volunteered their time to help with distribution?
Did you experience any of the following issues during food distribution?
1- Volunteer shortage
3- Produce quality (>20% unusable of particular item)
4- Weather delay
5- Delivery tardiness
6- Equipment damage/misuse
7- Altercation during MP service
8- Leftovers (>10% product invoiced)
Please describe issue(s) as checked above, as well as any resolutions or troubleshooting activities as/if applicable. *Note: Any complaints/grievances between clients, agencies/sites, and/or NTFB staff will require a separate, formal report.
# of hours worked by volunteers
If volunteers worked for different amounts of time, please add ALL volunteer hours together for this total.
Should be Empty: