Farmer Donation Data

Farm Feed Donation Data

Please tell us what you picked up today
Name

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

YesNo
Date of your scheduled pickup*

YearMonthDay
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
Enter the number of boxes. If nothing leave blank
Bakery
Enter the number of boxes. If nothing leave blank
Dairy
Enter the number of boxes. If nothing leave blank
Meat
Enter the number of boxes. If nothing leave blank
Deli
Enter the number of boxes. If nothing leave blank
Grocery
Enter the number of boxes. If nothing leave blank
Receiver ID
Box count must be more than 0.2

If no boxes were collected from a department leave the field blank
Should be Empty:

Farm Feed Donation Data