2025 Kroger January Food Drive – Agency Partner Form

Agency Information
Agency Name*
Agency Contact Name*
Agency Contact Email*
Agency Contact Phone*
Agency Reference Number*
Agency Food Donations*
- I Agree
The Agency is responsible for picking up all food donations for the staffed stores.
Fundraising Supplies Information*
- I Agree
The assigned agency agrees to return cash canisters and all other fundraiser supplies by the following Tuesday of the event.
Volunteer Agreement*
- I Agree
The assigned agency agrees to fully staff the agreed upon Kroger location with sufficient (4-6) volunteers per location.
Choose Your Volunteer Date & Location
Select your 1st Choice Volunteer Date & Kroger Location*
Select your 2nd Choice Volunteer Date & Kroger Location*
Select your 3rd Choice Volunteer Date & Kroger Location*

Agency Information