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
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:_____________________________________ 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 (Use back if needed):_____________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ |
|||||
Check One: |
|||||
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 Emily or Judy at 715-835-9415.