Monthly Service Statistics Report Form Food Pantry Programs

Due date: By 10th of following month (i.e. January due by February 10th)

When not to send a report: Never!
When to send zero report:
If you did not serve any food during the month
When to send regular counts: If you serve food, regardless of where the food is obtained

Fill out online or print it
and mail to:
Feed My People Food Bank
331 Putnam Street
Eau Claire, WI 54703-3573
Or fax to: 715-835-3844

Statistics are for the month and year of:

Agency:

Agency ID Number:

Contact Person:

Phone Number:

Address:

	Individuals Ages 0-17:	Individuals Ages 18 - 64	Individuals Ages 65+	Households	Pounds/ Vouchers
Regular Service (1st Visit this month)
Extra Service (2nd+ Visit this month)
Total for this month

Comments:

Check One:
Food and non-food products are weighed on a scale
Pounds are estimated

How to report Regular Service:

This is an unduplicated number. Each household counted here should be different. Therefore, only count a family's first visit this month in this section.

How to report Extra Service:

If you serve the same family more than once this month, report their additional visits here. For instance, if the same family comes three times this month, record their last two visits in this section.

How to report Pounds/Vouchers:

Everything that you distribute to a family during their food pantry visit should be reported here. That includes food and non-food products and cash or product vouchers redeemable at a store. All food and non-food items should be weighed on a scale. For vouchers, you may use the formula: 1 dollar = 1 pound.

If you are unsure of how to record your statistics or you have any questions, please call us at 715-835-9415.

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Testimonial

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“Having the ability to obtain food from Feed My People Food Bank allows us to provide more food to families with our available funds. For example, one year we provided 10,000 pounds more food than the year before for $5000 less. That's a great savings!”

Director of the Bloomer Food Pantry

Feed My People Food Bank | 331 Putnam Street | Eau Claire, WI 54703-3573 | 715.835.9415 | Site Map