Monthly Report
Please enter in your information below for your monthly report. If you have any difficulties or questions, please contact Nicole Hosler at nhosler@feedingamerica.org or (252) 335-4035 x104.
Email address
Month
Year
Agency Submitting Report
Your answer
Individual Submitting Report
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Type of Agency
Primary County Served
Number of BLACK families/households helped last month?
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Number of WHITE families/households helped last month?
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Number of HISPANIC families/households helped last month?
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Number of ASIAN families/households helped last month?
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Number of AMERICAN INDIAN families/households helped last month?
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How many OTHER RACE/ UNDECLARED families/households helped last month?
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How many households have at least one person who is employed?
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How many households receive Food Stamps (FNS)?
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How many households received disaster relief assistance?
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TOTAL Families/Households helped last month?
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Of the total families/households helped last month, how many were new (first visit) to your agency?
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How many individuals were aged: 0-4 Years Old
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5-17 Years Old
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18-64 Years Old
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65+ Years Old
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TOTAL INDIVIDUALS ASSISTED:
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We served households who live in zip code:
Please list the zip code, followed by a dash - and then the household number. Please put each zipcode on a separate line. For example: "27909 - 56"
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Phone Number of person completing report:
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A copy of your responses will be emailed to the address you provided.
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