Food Bank For New York City: Survey - Food Drive Registration Form

Food Drive Registration Form

Please complete this form to register your food drive.

1.

Enter contact information for your Food Drive Coordinator here:

*

Name:

First Required	Last Required	Suffix

*

Email: Required

*

Street 1: Required

Street 2:

*

City/State/ZIP:

City Required	State Required	ZIP Required

*

Phone Number: Required

Employer:

Yes, I would like to receive e-mail from Food Bank For New York City

Remember me. What's this?

2.

Question - Not Required - Fax Number:

3.

Question - Not Required - Number of Participants:

*4.

Question - Required - Our organization would like to help the Food Bank For New York City by (check all that apply):
Please make between 1 and 4 selections from the choices below.

	Collecting food to be picked up by the Food Bank (bins to be provided if necessary)
	Raising financial donations for the Food Bank's operations and food distribution
	Volunteering at the Food Bank
	Sponsoring Food Bank efforts

5.

Question - Not Required - Number of Food Bank Bins Needed:

6.

Question - Not Required - Delivery of Bins to Organization:

Month

Day

Year

7.

Question - Not Required - Pickup from Organization:

Month

Day

Year

8.

Question - Not Required - Additional Pickup/Delivery Date:

Month

Day

Year

9.

Question - Not Required - Please provide details for pickup/dropoff at loading docks or other secure areas. Without proper details, pickups/dropoffs can result in traffic violations incurred by Food Bank vans.

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

Our drivers make pickups and deliveries between 9am and 2pm, Monday through Friday. If your bin becomes more than 2/3 full, please request additional bins or use your own bins for the remaining food items. Each bin holds approximately 100 lbs of food.

10.

Question - Not Required - Other special instructions:

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

11.

Question - Not Required - Please provide the name, email and telephone number of the On-Site Coordinator, if different from above.

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