Community Grab-N-Go Distribution & Hunger Relief Questionnaire
Please complete the form below to request to be a Community Grab-N-Go Distribution Site as a part of FLIPANY's Hunger Relief efforts in Miami-Dade, Broward and Palm Beach Counties. All requests should be submitted at least 3 days prior to the date of need. Please note that meal service and a meal service start date should not be considered finalized at the time of submission. These details will be provided in a separate confirmation email once your request has been received and verified by the FLIPANY Staff.
Requestor's Name *
Requestor Contact Information [Please include name, phone number and email] *
Site Name *
Site Address *
Are you requesting meal service with the intent to operate as a Community Grab-N-Go Distribution Site? *
Please provide the date(s) for which you are requesting meal service *
Will your site operate as a Community Grab-N-Go Distribution Site daily or on specific days during the requested dates? If specific, please note which days under "Other" *
Estimated Number of Meals Needed *
Does your Site have sufficient Staff to operate as a Community Grab-N-Go Distribution Site? *
Will your Site need additional support to operate as a Community Grab-N-Go Distribution Site? *
Number of Volunteers Needed *
What is the earliest time of delivery for meals at your site? *
Time
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Is the person making this request also the contact person for delivery? If No, please provide additional contact under "Other." [Please include name, phone number and email] *
I, as the author of this request understand that a Community Grab-N-Go Distribution Site is a "Grab & Go" opportunity for parents to pick-up to 2 meals (breakfast/snack and lunch) per child, ages 18 and under that are present at the time of the request. I acknowledge that all meals must be given to children ONLY and accounted for at the time of service. *
I, as the author of this request understand that submission of this form does not guarantee an immediate start date as it must be reviewed by a member of the FLIPANY Staff. I also understand that confirmation of an official start date will be sent in a separate email once available and will include all pertinent details/information. *
Additional comments *
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