Food Pantry Template.docx

 FOOD PANTRY TEMPLATENote: All food pantries are unique. This template provides examples only. AGENCY OVERVIEWA church with worship services and charitable outreach, including a food pantry.A nonprofit, community-based food pantry serving Happy County.“The Hungry Hippos Community Food Pantry serves community members in need as part of its larger mission to honor hippopotamuses everywhere.” SERVICE GROUP 1:FOOD PANTRYFOOD AND CLOTHING PANTRYFOOD AND BABY PANTRYPROGRAM NAME: Include only if pantry has a specific name; do not simply repeat agency name.DESCRIPTIONDescribe items offered, any special information about service (such as “client choice” formats), whether a referral is required, whether an appointment is required, and (finally) whether the service as a limited or open service area.Provides food to persons in need. Open service area.Provides nonperishable food to persons in need. Fresh produce, toiletries, and cleaning supplies are sometimes available. Open service area for first visit.Provides basic food staples by appointment to persons in need. Limited service area or by written referral.Provides perishable and nonperishable food, hygiene supplies, and paper products to persons in need. Clients make their own selection from available items. Limited service area.PUBLISHED DESCRIPTIONSame as above EXCEPT: Instead of “Limited service area,” state area served:For pantries with street-by-street boundaries, provide general location of boundary area. For pantries that go by zip code, confirm with the pantry whether they serve only portions of that zip code within their county, or all in zip code. Phrase text (and set ServiceSite area) accordingly.For pantries that serve a township, state county name in addition to township name.Also add information about how often a person can use the service; maximum number of visits (if applicable), or frequency of pantry (if no maximum)Provides food monthly to persons in need. Open service area.Provides nonperishable food every other month to persons in need. Fresh produce, toiletries, and cleaning supplies are sometimes available. After the first visit, service is limited to persons living in Boone County.Provides basic food staples by appointment to persons in need who live within set boundaries in southeastern Marion County or who have a written referral from a social service agency. Limit one visit per month.Provides perishable and nonperishable food, hygiene supplies, and paper products to Perry County persons in need. Clients make their own selection from available items. Limit one visit every 30 days.Provides food each week to persons in need who live within the Hamilton North School District boundaries.HOURSNo need to preface hours with “Pantry:” if only pantry hours are being listed. If appointments are required, provide hours for scheduling as well as pantry hours (if set)If all clients must sign in by a set time, list only that time (and give some indication that it is a sign-in time). If start time is set, but end time is not, list as appropriate. For example: “until all food is gone” or “Pantry may end early if food runs out.”Mon 10am-4pm ETSign-In: Tues 1pm ETMonthly 2nd Thurs 6pm ET until food runs outPhone/Scheduling: Vary; voicemail availablePantry: Thurs 8am-4pm ET, by appointmentPhone/Scheduling: Mon-Fri 8am-5pm ETPantry: Thurs by appointment onlyPhone/Scheduling: Mon-Fri 8am-5pm ETPantry: By appointment onlyELIGIBILITYIf limit on number of visits is the only eligibility, use “Open;” followed by “limit x visits per y”If there are additional criteria besides number of visits; list # of visits at the end, phrased either as “Not used this pantry within the past ___” OR, if necessary to prevent confusion, “Limit x visits per y”If stating geographic boundaries in terms of streets, townships, or other identifiers that could be ambiguous, include county (or city) name.Do not list income guidelines unless proof of income is required, or unless agency insists on listing them.OpenOpen, limit one visit per month* Living in Madison County* Not used this pantry within the past 30 days* Living within boundaries: N-38th St.; S-Ohio St.; E-Meridian St.; W-White River in Indianapolis* Limit two visits per month* Living in Washington Township of Hamilton County* With referral from a church, school, trustee, or social service agencyINTAKEDo not include information about specific procedures once the client arrives unless there is a chance the client won’t be told what to do when they get there. (For example, don’t include “complete short intake form” or “sign in” unless, for example, the there is an unattended clipboard that the client must sign on arrival in order to save his/her space in queue. Walk in; use Entrance 3.Call to schedule an appointment. Same or next-day appointments are often available.Walk in; arrive early for best chance of service. Line forms along south wall of the church. WHAT TO BRINGNothing needed* State-issued photo ID* Proof of current address, if different from address on ID* Photo ID* Proof of current address (such as recent utility bill, lease, or official mail)* Proof of household income (such as most recent paystub, WorkOne wage printout, Social Security benefits statement, etc.)FEESNoneTaxonomiesArea ServedMatchlist NotesConditionsFood PantriesFor Limited Service Area: Smallest area that includes ALL eligible households.For Open Service Area: All areas that might reasonably travel to the pantry for this service (may be the county; county and surrounding counties; county neighboring zip codes, etc.) Note 1: Monthly 3rd Wed 2pmNote 2: Serves Marion CountyNote 1: By appointment onlyNote 2: Open service areaNote 1: By appointment only; same-day app’ts possibleNote 2: Serves zip code 46220Set Day of the Week conditions.For “by appointment only” pantries, set days of week conditions for days that pantry visit MAY be scheduled (particularly if same or next day app’ts available) ................
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