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Local Agency Monthly Statistical Report

Fields marked with an * are required
Complete appropriate Statistical Sections. Reports must be submitted to the foodbank no later than the 15th of the month following the month to which the report pertains.
Food Pantry: A part of a foodbank network that distributes food and grocery products to low-income households, including food from sources other than USDA, to relieve situations of emergency and distress. It is housed in a standing facility that distributes commodities, among other food and grocery products, on a regular basis. Food Pantry Statistical Section Number of Households
Number of Seniors Served (age 60+)
Number of Adults Served (18-59)
Number of Children Served (Birth - 17)
Total Number of People Served

Meal Site Statistical Section
Congregate or Residential Meals: Primary service is not food distribution; but meals are included as part of the services provided, including Residential Treatment Facilities, Child or Adult Day Care, Senior Citizen Center, Group Home, Youth Program, Summer Camp, etc. Congregate and/or Residential Meals Statistical Section*
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