Potential Distribution Screening Form
Thank you for your interest in partnering with the Food Bank of North Alabama in a distribution! We are proud to support our agencies and partners across our 11 county service area through a number of partnership models. The following interest form is designed to help the Food Bank identify which distribution model will be a best fit for your organization, so please take your time and answer the following questions as accurately and thoroughly as possible. Please note that submission of a completed application does not guarantee your site will be selected to partner with the Food Bank of North Alabama. Our Special Programs department will review applications in the order they are received AND in accordance with the community need. Sites approved for partnership will be contacted via the contact information listed in your application.
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Organization Name
Organization Type
501(c)(3) Nonprofit
Church
Other
Are you currently a partner/agency with the Food Bank of North Alabama?
Yes
No
Physical Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County
Please Select
Lauderdale
Limestone
Colbert
Franklin
Lawrence
Madison
Morgan
Cullman
Jackson
Marshall
DeKalb
Main Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Main Contact Email Address
example@example.com
Secondary Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Contact Email Address
Does your Organization have an active social media page?
Yes
No
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Service Goals and Capacity
Will this distribution take place at the site listed? If another site, please list address in the "No" field
Yes
No
Are you already distributing food to your community?
Yes - we are already distributing food
No - we are looking to start a food distribution
How many clients are you currently serving each week?
How many volunteers do you have?
What distribution models do you currently do?
Client Choice Model
Pre-bagged Model
Drive-Thru
Farmer's Market
Emergency
Other
What type of storage capacity do you have?
Refrigerator
Freezer
Dry Storage Shelving
None
Other
What type of transportation do you have access to? (select all that apply)
Small/Medium sized personal vehicles (car, mini-van, small sedan, etc)
Large personal vehicles (pick-up truck, passenger van, etc)
Box truck/U-Haul (non-refrigerated)
Box Truck/U-Haul (refrigerated)
None
Other
What demographic information can you provide about the population you are interested in serving?
Is there any other information pertaining to your organizational goals or limitations that you would like the Food Bank of North Alabama to know?
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I understand that this is a screening form, not an application for Food Bank partnership.
*
I understand
I understand that completion of this screening form does not guarantee partnership with the Food Bank.
*
I understand
Submit
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