Pennsylvania Farm Bureau - Pennsylvania Farm Bureau

Harvest for All Donation Report
Name of Food Bank*
Name of Person Submitting Report*

First NameLast Name
Email*
example@example.com
County Farm Bureau*
Phone # of Person Submitting Report*

Area CodePhone Number
$ Amount of Donation
Volunteer Hours Spent
Total Weight in pounds (lbs) of Donation
Date*

MonthDayYear
Date
Date

MonthDayYear
Second Date
Date

MonthDayYear
Third Date
Comments or Requests
Enter the security message as it's shown*
Should be Empty: