Monthly Reporting Form

Please fill out the form below to report your monthly food distribution.

About You
Agency Name*
Agency ID Number*
This Report Was Prepared By*
Phone*
Email*
This report reflects activity in the month of:
Month*
Year*
If You Distribute Food

Please fill out this section:
Total Number of People Helped This Month
Total Number of Families Helped This Month
Total People (By Age Group) That Were Given Food:
6 Years Old & Under - DIS
6 Years Old & Under
Please enter a number from 0 to 1000.
7-18 Years Old - DIS
7-18 Years Old
Please enter a number greater than or equal to 0.
19-54 Years Old - DIS
19-54 Years Old
Please enter a number greater than or equal to 0.
55+ Years Old - DIS
55+ Years Old
Please enter a number greater than or equal to 0.
Your Total People Served (By Age)
Please ensure this number matches the total number of people helped that you reported above.
Total People (By Race) That Were Given Food:
Black or African American - DIS
Black or African American
Please enter a number greater than or equal to 0.
Asian - DIS
Asian
Please enter a number greater than or equal to 0.
Hispanic or Latino - DIS
Hispanic or Latino
Please enter a number greater than or equal to 0.
White - DIS
White
Please enter a number greater than or equal to 0.
American Indian or Alaskan Native - DIS
American Indian or Alaskan Native
Please enter a number greater than or equal to 0.
Native Hawaiian or Pacific Islander - DIS
Native Hawaiian or Pacific Islander
Please enter a number greater than or equal to 0.
Middle Eastern or North African - DIS
Middle Eastern or North African
Please enter a number greater than or equal to 0.
Multi-Racial/Ethnic - DIS
Multi-Racial/Ethnic
Please enter a number greater than or equal to 0.
Client Prefers Not to Disclose - DIS
Client Prefers Not to Disclose
Please enter a number greater than or equal to 0.
Other - DIS
Other
Please enter a number greater than or equal to 0.
Your Total People Served (By Race)
Please ensure this number matches the total number of people helped that you reported above.
If You Serve Meals - Residential

Please fill out this section (scroll down for community meals):
TOTAL NUMBER OF MEALS SERVED THIS MONTH
TOTAL NUMBER OF UNDUPLICATED PEOPLE FED THIS MONTH
TOTAL PEOPLE (BY AGE GROUP) THAT WERE GIVEN FOOD:
6 Years Old & Under - RES
6 Years Old & Under
Please enter a number greater than or equal to 0.
7-18 Years Old - RES
7-18 Years Old
Please enter a number greater than or equal to 0.
19-54 Years Old - RES
19-54 Years Old
Please enter a number greater than or equal to 0.
55+ Years Old - RES
55+ Years Old
Please enter a number greater than or equal to 0.
YOUR TOTAL PEOPLE SERVED (By Age)
Please ensure this number matches the total number of people helped that you reported above.
TOTAL PEOPLE (BY RACE) THAT WERE GIVEN FOOD:
Black or African American - RES
Black or African American
Please enter a number greater than or equal to 0.
Asian - RES
Asian
Please enter a number greater than or equal to 0.
Hispanic or Latino - RES
Hispanic or Latino
Please enter a number greater than or equal to 0.
White - RES
White
Please enter a number greater than or equal to 0.
American Indian or Alaskan Native - RES
American Indian or Alaskan Native
Please enter a number greater than or equal to 0.
Native Hawaiian or Pacific Islander - RES
Native Hawaiian or Pacific Islander
Please enter a number greater than or equal to 0.
Middle Eastern or North African - RES
Middle Eastern or North African
Please enter a number greater than or equal to 0.
Multi-Racial/Ethnic - RES
Multi-Racial/Ethnic
Please enter a number greater than or equal to 0.
Client Prefers Not to Disclose - RES
Client Prefers Not to Disclose
Please enter a number greater than or equal to 0.
Other - RES
Other
Please enter a number greater than or equal to 0.
YOUR TOTAL PEOPLE SERVED (BY RACE)
Please ensure this number matches the total number of people helped that you reported above.
If You Serve Meals - Community

Please fill out this section:
TOTAL NUMBER OF MEALS SERVED THIS MONTH
NUMBER OF DAYS MEALS WERE SERVED THIS MONTH
TOTAL PEOPLE (BY AGE GROUP) THAT WERE GIVEN FOOD:
6 Years Old & Under - COM
6 Years Old & Under
Please enter a number greater than or equal to 0.
7-18 Years Old - COM
7-18 Years Old
Please enter a number greater than or equal to 0.
19-54 Years Old - COM
19-54 Years Old
Please enter a number greater than or equal to 0.
55+ Years Old - COM
55+ Years Old
Please enter a number greater than or equal to 0.
Your Total People Served (By Age)
Please ensure this number matches the total number of people helped that you reported above.
Total People (By Race) That Were Given Food:
Black or African American - COM
Black or African American
Please enter a number greater than or equal to 0.
Asian - COM
Asian
Please enter a number greater than or equal to 0.
Hispanic or Latino - COM
Hispanic or Latino
Please enter a number greater than or equal to 0.
White - COM
White
Please enter a number greater than or equal to 0.
American Indian or Alaskan Native - COM
American Indian or Alaskan Native
Please enter a number greater than or equal to 0.
Native Hawaiian or Pacific Islander - COM
Native Hawaiian or Pacific Islander
Please enter a number greater than or equal to 0.
Middle Eastern or North African - COM
Middle Eastern or North African
Please enter a number greater than or equal to 0.
Multi-Racial/Ethnic - COM
Multi-Racial/Ethnic
Please enter a number greater than or equal to 0.
Client Prefers Not to Disclose - COM
Client Prefers Not to Disclose
Other - COM
Other
Your Total People Served (By Race)
Please ensure this number matches the total number of people helped that you reported above.

Please fill out the form below to report your monthly food distribution.

About You

If You Distribute Food

If You Serve Meals - Residential

If You Serve Meals - Community

Committed to Excellence

Helpful Links

Newsletter Sign-Up

Stay informed about our work.