New Recipient Agency Request
If your agency is interested in receiving food from We Don't Waste, please fill out this form. A staff member will contact you to follow up.
Agency Name *
Your answer
Agency address *
Your answer
Primary contact name *
Your answer
Primary contact title
Your answer
Contact email address *
Your answer
Contact phone number *
Your answer
Which category best describes your organization? *
What types of food-related services does your agency offer? Please check all that apply.
Do people eat meals on site?
What hours are you open to clients? Please include hours of operation for each day of the week and/or specific details (i.e.: "open the 2nd Monday of the month," etc.). *
Your answer
What days/times are best for We Don’t Waste to bring you food? Please select all times that are applicable.
Morning (8am to noon)
Afternoon (noon to 5pm)
Monday
Tuesday
Wednesday
Thursday
Friday
Estimated number of unduplicated clients that your organization served with food during your most recently completed fiscal year? (the unduplicated number means the unique individuals that you have served, ex: "We served 100 unique individuals last year") *
Your answer
Estimated number of duplicated clients that your organization served with food during your most recently completed fiscal year? (The duplicated number would be the total number served, ex: Sally received food 9 times over the course of a year, making the duplicated count "9") *
Your answer
Do you serve any specific populations? Please select all that apply: *
Required
Do you have freezer space? *
Do you have refrigerator space? *
Do you have storage space? (ex: for shelf-stable foods, dry-goods, etc.). *
Is food always kept at least 6 inches off of the floor and away from walls?
Is the temperature of your refrigerator kept below 40 degrees at all times? *
Is the temperature of your freezer kept below 0 degrees at all times? *
What types of food are you most in need of? Check all that apply. *
Required
Is there anything else you think we should know?
Your answer
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