Agency Name: Agency Number: Does your agency have a vehicle capable of transporting up to 400 pounds of product? Yes No What condition is the vehicle in? Excellent Good Fair Poor How many days per week is the vehicle available exclusively for store pick-ups? 1 2 3 4 5 6 7 Which days is the vehicle available? Sunday Monday Tuesday Wednesday Thursday Friday Saturday Is the vehicle refrigerated? Yes No Please describe the vehicle you would use for store pick-ups? (Make/model/year) Does your agency have a designated staff person or volunteer who would manage store pick-ups? Yes No Would store pick-ups be managed by a paid staff member or a volunteer? Paid staff Volunteer How many days per week would the staff person/volunteer be available exclusively for store pick-ups? 1 2 3 4 5 6 7 Which days are they available? Sunday Monday Tuesday Wednesday Thursday Friday Saturday Please describe your facility's storage capacity: Freezer Space Please describe your facility's storage capacity: Cooler Space Please describe your facility's storage capacity: Shelving Space Does your agency have a designated staff person or volunteer who will be available to record and report storage poundage to Food Bank of Central New York by the necessary deadlines? Yes No Would your agency be willing to complete any food safety trainings deemed necessary by Food Bank of Central New York in order to manage store pick-ups? Yes No Would your agency be willing to share store product with other Food Bank members? Yes No Please describe your plan for the disposal of donated goods that are unusable? (Trash, compost, farm donation, etc.) Please add any further comments:
