Commodity Supplemental Food Program – Senior Boxes Interest

Commodity Supplemental Food Program (CSFP) – Distribution Site Interest Form

Thank you for your interest in participating in our CSFP program serving seniors in our community. Please complete the following form and our team will be in touch with you to discuss the next steps.

Agency Name(Required)

Agency Address(Required)

Contact Name(Required)

Contact Title(Required)

Contact Email(Required)

Contact Cell Phone(Required)

Does your organization receive CSFP or senior food boxes from another organization, such as Focus Hope or OLHSA?(Required)

How many seniors (age 60+) do you currently serve through your location through non-CSFP programs?(Required)

Can you enroll 40-50 seniors in the CSFP senior food box program?(Required)

Do you have adequate staff to manage client applications, check client IDs, and distribute boxes?(Required)

Can you commit to complete and accurate reporting of boxes distributed each month?(Required)

Are you willing to take Civil Rights Training each year?(Required)

Do you have refrigeration/cooler space available for the cheese (one two-pound block per person)? (Even if you do same day distribution, you must have refrigerated space available in case of no shows or returns.)(Required)

Do you have adequate storage available for the boxes? Boxes are 12”x12”x12” each and must be kept off the floor in a well-ventilated area that is free from pests(Required)

How do you plan to distribute the boxes each month? (Pickup/Delivery)(Required)

Commodity Supplemental Food Program (CSFP) – Distribution Site Interest Form

Join Us

DONATE

VOLUNTEER

NEWS

EVENTS & FOOD DRIVES

Stay Connected!

Proud Member of: