Double Up Food Bucks Oregon Prospective Grocery Store Application
Thank you for your interest in the Double Up Food Bucks Oregon (DUFB) Grocery pilot program! Please answer the following questions to tell us about your store. If you have questions about the program or this application, please reference the overview document or contact Ryan Schoonover (rschoonover@oregonfoodbank.org or (503) 575-2101).

All applications will be reviewed in December and January. Selected stores will be notified in February.
Email address *
Store Ownership and Contact Information
Store Name *
Your answer
Store Address *
Street Address / City / State / Zip Code
Your answer
Please provide a brief history of the store (when it opened, recent changes in ownership or management, past uses/ownership of premises, any recent investments or renovations) *
Your answer
Store Phone Number *
Your answer
Primary Contact Name *
First and last name
Your answer
Email *
Your answer
Phone number *
Your answer
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