Farmer Donation Data

Verified Farmer

Name

First NameLast Name

Farm Feed Donation Data

Please tell us what you picked up today

Did you complete your pickup today/was there anything to pickup?*

YesNo

Date of your scheduled pickup*

What store were you scheduled to pickup from?*

Why did you not complete your pickup today?*

Nothing was available for pickupI couldn't make it to the store

Enter the number of boxes you picked up for each department. Leave the field blank if you didn't collect boxes from a department.

Produce