Prospective Agency Questionnaire
Help us evaluate if you would be a good fit for partnership. This is just a preliminary screening. If you meet our standards, we will follow up with you to let you know if you qualify for partnership.
Name of Organization
*
Organization Phone Number
*
Please enter a valid phone number.
Organization Email
*
example@example.com
Pantry Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Point of Contact
*
First Name
Last Name
Point of Contact Phone Number
*
Please enter a valid phone number.
Point of Contact Email
*
example@example.com
Is your organization a private foundation?
*
Yes
No
Are you a 501c3?
*
Yes
No
If you are NOT a 501c3, are you a church?
Yes
No
Do you currently operate a food pantry serving food to needy individuals/families?
*
Yes
No
If yes, please provide days and times you serve. (Ex: Mondays 4-6pm)
If yes, are you targeting certain neighborhoods, age groups, communities, etc.?
If no, what areas of the community do you plan on serving?
If no, what days and times do you or do you plan to distribute food? (Ex. Weds 2-4pm, Fridays 5-7pm)
Do you have a kitchen where you currently prepare meals to feed the needy community? (not your church congregation)
Yes
No
If yes, please explain.
Check the supplies you currently have.
*
Storage
Shelving
Refrigerator(s)
Freezer(s)
Cooler(s)
Freezer Blanket(s)
How many refrigerators do you have?
How many freezers do you have?
Would you like to pick up food from local grocery stores to add free food to your pantry? This is called Retail Rescue. This program requires that you distribute several times a month.
Yes, we want to participate
No, we don't want to participate
Do you have the ability to pick up your own food from the Foodbank?
*
Yes
No
Do you have your own volunteers?
*
Yes
No
Thanks for filling out this questionnaire. There are certain criteria that we are looking for when we bring new partners onboard. The more detail you can provide the better.
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