My organization will hold: A food drive only A food and fund drive

Name of organization:

Organization's mailing address:

City: Zip code:

# of employees, students, or members:

My organization is best described as: For-profit Non-profit School Club Event* Service Group Other

Contact Name:

Title:

Phone Number: Extension:

Fax Number:

Email Address:

Alternative Contact Name:

We ask all participants to pick up boxes and deliver collected food in an effort to use the Food Bank's resources in the most effective manner. The Food Bank will provide pick up for those food drives that collect two or more boxes (at least 400 pounds) of nonperishable food.

Date(s) of Drive (04/01/03-12/01/03):

My organization will need (#) poster(s) and (#) box(es) from the Food Bank.  box will hold up to 300 pounds or 300 cans of food.

My organization's goal is to raise pounds of food.

Please choose one:

My organization will pick up boxes from the Food Bank on (mm/dd/yy) at :        (hour:minute) (am/pm) Monday through Friday from 7a.m. to 5p.m.

My organization requests the delivery of boxes. Food Bank will notify me of available dates.
      Major Intersection:
      Hours and days of operation:
      Driver will enter front door unless specified here:

Please choose one:
My organization will deliver collected food to the Food Bank on (mm/dd/yy) at
      :(hour/minute) (am/pm). Monday through Friday from 7a.m. to 5p.m.

My organization requests the pick up of collected food. The Food Bank will notify me of available dates.
      Major Intersection:
      Hours and days of operation:
      Driver will enter front door unless specified here:

In addition to holding a food drive, my organization would like to: Schedule a tour of the Food Bank
Volunteer to sort food at the Food Bank
Arrange for a Food Bank speaker to visit my organization
Request free literature on hunger in our community