Partner Agency Interest Form

 

Thank you for your interest in partnership with Second Harvest Heartland. Please note: This is NOT an official partner application or a guarantee of partnership with the food bank.

Before you fill out and submit the following form, please review this document to help determine if a Second Harvest Heartland partnership may be a good fit for you.

 

Partner Agency Interest Forms are reviewed on a weekly basis. We greatly appreciate your interest in partnership and look forward to reviewing your program information. After review, you will receive an email or phone call providing you with an update on your status and informing you if your program will be invited to submit a full application for partnership.

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Question - Required - Does your organization have a 501c3, non-profit status? (Valid 501c3 status is required for partnership with Second Harvest Heartland.)



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(Maximum response 255 chars, approx. 5 rows of text)

 

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* Program Type:
(Select one of the available choices or enter a different value.)



   


 

(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - What are your funding sources? Select all that apply.
Please make at least 1 selection from the choices below.

 

(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - What are your current food sources?
Please make at least 1 selection from the choices below.

 

(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - What capacity do you have for food storage?
Please make between 1 and 3 selections from the choices below.

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(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - Record-keeping system for clients served:

   


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(Maximum response 255 chars, approx. 5 rows of text)

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