Gleaners Partner Agency Inquiry Form

Gleaners Partner Agency Inquiry Form

Inquiry Form for 501(c)3 organizations wishing to partner with Gleaners Community Food Bank to distribute food in Wayne, Oakland, Macomb, Monroe or Livingston counties.
Thank you for expressing interest in partnering with Gleaners Community Food Bank! Gleaners will review all inquiry forms and make determinations based on capacity in the area and available resources. We actively review applications for membership during the months of April through August. Due to the volume of interest, it may take up to 4 weeks to receive a response from us regarding your inquiry form. We cannot guarantee that applicants will be accepted into our food distribution program.
Organization's Name (as it appears on your 501(c)3 letter from the IRS)*
Food Distribution Program Name (if different from what is listed on your IRS letter)
Address (where you plan on storing/distributing food)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Main Contact Name*

First NameLast Name
Main Contact Title*
Main Contact Phone #*
Please enter a valid phone number.
Main Contact Email*
example@example.com
Secondary Contact Name

First NameLast Name
Secondary Contact Title
Secondary Contact Phone #
Please enter a valid phone number.
Secondary Contact Email
example@example.com
Link to your website (if applicable)
Link to your Facebook page (if applicable)
Describe your service area (what cities/zip codes do you serve?)*
Type of Program(s)*

Food PantrySoup KitchenShelterResidential ProgramOther
Distribution Style*

Hot mealsShop in pantryPre-bagged foodPre-order to allow for client choiceOther
Are you able to store food at your location?*

YesNo
How many refrigeration (cooler) units do you have?*
How many freezer units do you have?*
When did your feeding program begin?*
How many households are you serving each month?*
What are your current sources of food?*
What is your monthly budget for food?*
How is your food program funded?*
How many people (staff and volunteers) work in your food distribution program?*
Type of Food Safety certification:*
Food Safety expiration date:
Please provide your food distribution hours of operation (days, times, frequency throughout the month).*
Please explain your food distribution operation.*
How do individuals receive food from you?
Is there anything else you would like to share about your organization?
Upload your IRS Letter verifying your organization's 501(c)3 public charity status as a non-profit.

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Upload any other files -- brochures, flyers, etc. that speak to your organization's work and food distribution efforts.

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