2021 Satellite Pantry Application — Our Daily Bread Food Bank

2021 Satellite Pantry Application
Please only complete one application per pantry.
Download package here

Satellite Pantry Name

Satellite Pantry Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Pantry Day(s)

Pantry Time(s)

Director Name

First Name

Last Name

Director Phone Number

(###)

###

####

Director Email

Assistant Director Name

First Name

Last Name

Assistant Director Phone Number

(###)

###

####

Assistant Director Email

Pastor Name

First Name

Last Name

Pastor Phone Number

(###)

###

####

Pick-Up Contact Name

First Name

Last Name

Pick-Up Contact Number

(###)

###

####

Pick-Up Day

Only Monday, Tuesday, Thursdays, or 3rd Saturday of the month.

Pick-Up Time

8-2

Who is ServSafe Certified at your site?

First Name

Last Name

Do you store cold items?

Any pantry that stores cold items must record temperature logs every 24 hours that food is stored. Records must be kept for 3 years. Any violations to this rule can result in immediate closure.

Do you have clean and adequate space to store dry goods off the floor?

Is this your first time applying to be a satellite pantry site?

If you are currently a satellite pantry choose NO

2021 Satellite Pantry ApplicationPlease only complete one application per pantry.Download package here

“Gather the pieces that are left over. Let nothing be wasted.” John 6:12

2021 Satellite Pantry Application
Please only complete one application per pantry.
Download package here