Brown County Food and Hunger Coalition Reporting Form 
Please use this form to enter your monthly pantry statistics for UW-Extension and the Brown County Food and Hunger Coalition Database. 

Please skip any questions which are not applicable or for which you do not have information. 

If you have any questions about this form, please contact the Extension office at: 920-391-4640.
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Email *
These statistics are for the month of *
These statistics are for the year *
Enter your first and last name *
Enter your daytime phone number *
Select the name of the food pantry *
Number of Unduplicated Households Served *
Number of Unduplicated Adults Served *
Number of Unduplicated Children and Infants Served *
Weight of food distributed (1 lb. equals one item) 
Use this space to include any additional comments.
A copy of your responses will be emailed to the address you provided.
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