TEFAP Monthly Report

Monthly Report

TEFAP Agencies (Onsite Pantry, Onsite Feeding)
Agency Name*
Agency ID#*
What Month are You Reporting For?*
Did you conduct a DistributionDuring this Month?*

YesNo
Person Completing the Report*

First NameLast Name
Email*
example@example.com
Date*

MonthDayYear
Date
Total Households Served*
Total Households with Children 18 & Under*
Total Individuals Served*
# of Adults 19-59*
# of Children 18 and Under*
# of Seniors 60 and Over*
# of Veterans *
What Day(s) Do You Serve?*
What Time(s) Do You Serve?*
Please verify that you are human*
Should be Empty: