Akron-Canton Regional Foodbank Monthly Reporting Form
Every Network Partner is required to submit a Monthly Statistical Report. Reports must be submitted to the Foodbank no later than the 10th of the month following the month to which the report pertains (i.e. the monthly report for June is due by July 10th) Please complete the appropriate sections of the form below that match your program(s). Network partners failing to submit reports in a timely manner are subject to suspension.

Upon receipt, you will receive email confirmation that your report was received, along with a copy of the submitted report. Please keep this copy in your agency records for 5 years. If you do not receive a confirmation email within 1 day (it may be placed in your spam folder), please contact the Network Partners and Programs Department.

If you already have an electronic copy of the monthly report form you may email it to monthlyreports@acrfb.org and include the attachment.

Please use Google Chrome, Mozilla Firefox, or Microsoft Edge to complete this form. Internet Explorer is NOT compatible with the Monthly Reporting Form.

Name of Agency *
Your answer
Account # *
Your answer
Agency Street Address *
Your answer
Agency City *
Your answer
Agency Zip Code *
Your answer
County *
Please select response
Month *
Please select the month for which this report is being submitted.
Year *
Please select the year for which this report is being submitted.
First and Last Name of Person Submitting Report *
Your answer
Phone *
Your answer
Email *
(please double check for errors, a confirmation email will be sent here)
Your answer
What type of program(s) do you operate? *
Required
FOOD PANTRY
Food Pantry Definition: A part of a Foodbank network that distributes food and grocery products to low-income households, including food from sources other than USDA, to relieve situations of emergency and distress. It is housed in a standing facility that distributes commodities, among other food and grocery products, on a regular basis.

Totals will be automatically calculated when you receive your report. If your pantry program did not operate during the month reporting, please explain why in the Food Pantry Comments section below.

Households
Number of households WITH children
Your answer
Number of households WITHOUT children
Your answer
Seniors (age 60+)
Number of seniors served in households WITH minor children
Your answer
Number of seniors served in households WITHOUT minor children
Your answer
Adults (age 18-59)
Number of adults served in households WITH minor children
Your answer
Number of adults served in households WITHOUT minor children
Your answer
Children (age Birth-17)
Number of Children
Your answer
Food Pantry Comments
If there is updated contact information above, please note that here.
Your answer
MEAL SITE AND/OR SHELTER
Meal Site Definition: Provides meals to people in need.
Shelter Definition: Provides nights of shelter to homeless people or victims of abuse with no required programming during stay.

If your meal/shelter program did not operate during the month reporting, please explain why in the Meal Comments section below.

Number of PEOPLE served
Head Count
Your answer
Number of MEALS served
Plate Count
Your answer
Meal Comments
If there is updated contact information above, please note that here.
Your answer
CONGREGATE AND/OR RESIDENTIAL MEALS
Includes programs whose primary service is not food distribution; but meals/snacks are included as part of the services provided. Includes Residential Treatment Facilities, Child or Adult Day Care, Senior Programs, Group Homes, Youth Programs, Summer Camp, etc.

If your program did not operate during the month reporting, please explain why in the Non-Emergency Comments section below.

Non-Emergency Number of PEOPLE served
Head Count
Your answer
Non-Emergency Number of MEALS served
Plate Count
Your answer
Non-Emergency Comments
If there is updated contact information above, please note that here.
Your answer
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