Empowerment Partner Interest Request Form
If you or your organization would like to discuss opportunities to partner through services rendered at a Feeding Tampa Bay location or program, please submit this interest form and a member of our Neighbor Services team will follow-up directly.
Contact Information
Please provide information for your main point of contact.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Our Neighbor Services team will reach out to the contact information provided above.
Organization Information
Help us learn more about your organization
Organization Name
*
Please describe your organization type or mission/purpose
*
Does your organization have 501(c)(3) status?
*
Please Select
Yes
No
Unsure
What services do you provide? Please list all services you hope to provide onsite or share information about.
*
What counties do you serve?
*
Citrus
Hardee
Hernando
Highlands
Hillsborough
Manatee
Pasco
Pinellas
Polk
Sumter
Are your services zip code restricted?
*
Please Select
Yes
No
What zip codes do you serve?
Do you partner with Feeding Tampa Bay in other ways?
*
Please Select
Yes
No
Unsure
Please describe
Request Information
Help us learn more about how you would like to partner
Where are you looking to partner?
*
New Facility - Causeway Center
Feeding Pinellas Empowerment Center
Trinity Cafe 1 - Nebraska
Trinity Cafe 2 - Busch
Mobile Pantries
Community Agency Partner
Other
What best describes your partnership request?
*
Circulating Partner Flyers/Information
Providing Services On Site
Distributing Partner Goods (ie diapers, hygiene kits, etc.)
Other
Please attach any resource flyers or collateral you are hoping to share with the community.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please provide any additional details relevant to your request not captured above.
I understand that Feeding Tampa Bay does not permit provision of services where personal commissions are earned based off of neighbor registrations or enrollment in services or programs.
*
Yes
Submit
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