Receiving Agency Interest Form

Receiving Agency Registration

Fill out the application below to start the process of becoming a Food Forward Receiving Agency. Please note: We currently have a waitlist for all of our food recovery programs and we appreciate your patience. If you have any questions about the application please email agencyrelations@foodforward.org.

"*" indicates required fields

1Organization

2About Your Organization

3Transport Vehicles

4Distribution Sites

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[ Unique ID ]

/* This is a unique ID that is automatically generated and shared with the child Distribution Site records. There is code in the functions.php file that generates this. It is used in Salesforce for relate the records to one another. */

Organization Name*

0 of 255 max characters

Organization Legal Name*

0 of 255 max characters

Website URL

Employer Identification Number (EIN)*

IRS 501(c)(3) determination letter

Accepted file types: pdf, jpg, png, Max. file size: 10 MB.

Organization Mailing Address

Street Address City State ZIP Code

Administrative Contact

Name

Title

0 of 255 max characters

Personal Pronouns

Work Phone

Mobile Phone

Type

Preferred Language

Preferred Contact Method

Secondary Contact

Same as Admin

Same as Administrative Contact

Name

Title

0 of 255 max characters

Personal Pronouns

Work Phone

Mobile Phone

Type

Preferred Language*

Preferred

Social Media

Instagram

Facebook

Transport Vehicles

What type of vehicle does your organization use for food transport?

Transport Vehicles

Sedan

Minivan

Van

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Pickup Truck

Choice number 5 does not have an image

Stake Bed Truck

Choice number 6 does not have an image

Semi-truck

Choice number 7 does not have an image

Box Truck

Choice number 8 does not have an image

Other

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[ Transport Vehicles ]

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[ Semi Truck:107-to-108 ]

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[ Semi Truck:81-to-116 ]

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[ Semi Truck Size ]

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[ Box Truck:82-to-113 ]

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[ Box Truck:83-to-114 ]

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[ Box Truck Size ]

Distribution Sites

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[ Locations Count ]

/* Automatically counts the number of items in the Distribution Site list. Uses this number on the Entry ID for the Location to match in Salesforce. */

Distribution Sites

Distribution Site Name	No. of People Served	Distribution Site Address	Actions
There are no Distribution Sites.

Does your organization redistribute to secondary agencies?

Terms of Agreement

Terms of Agreement*

In order to become a Food Forward Receiving Agency, an organization must:

1. agree that it, or the organization of which it is a local chapter or affiliate, as applicable, shall maintain its status as a not-for-profit, tax-exempt organization under section 501(c)(3) of the Internal Revenue Code of 1986, as amended; and
2. offer all of the produce it receives from Food Forward to any person struggling with food insecurity, without any financial cost or any other mandatory requirements or exclusions.

I agree to the above terms

Receiving Agency Interest Form