Survey - Individual Food Drive Registration Form

Thank you for your interest in hosting a food drive!

This form is for Individuals raising 400lbs of food or more and are interested in having Food Bank drop off and pick up collection bins at your site. Please Note: there is a minimum requirement of 4 bins (100 lbs each) to have Food Bank drop-off bins at your site. Bins are 2’ L X 2’ W X 3’ H.

Simply fill-out and submit the form below to complete your registration. A member of our logistics team will contact you within 48 hours to arrange the pick-up and drop-off of your collection bins.

If you are an individual collecting less than 400lbs of food, we encourage you to raise meals for Food Bank using our online Food Drive tool. It's easy to use, and will allow you to rally your family, friends, and followers to raise money in the fight to end hunger! Get started here. If you are a K-12 school or college/university, register here. Please find the list of preferred items for a food drive here.

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

2.

Question - Not Required - Number of Participants:

*3.

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

4.

Question - Not Required - Bins are 2' x 2' x 3'. Number of Food Bank Bins Needed:

5.

Question - Not Required - Delivery of Bins to Organization:

Month

Day

Year

6.

Question - Not Required - Pickup from Organization:

Month

Day

Year

7.

Question - Not Required - Additional Pickup/Delivery Date:

Month

Day

Year

8.

Question - Not Required - Please provide details for pickup/dropoff at loading docks or other secure areas. Please determine if your building requires a COI for our vehicle.

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

Our drivers make pickups and deliveries between 7:30 am and 4:30 pm, 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.

9.

Question - Not Required - Other special instructions:

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

10.

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)