Double Up Food Bucks Retail Application Request

Introduction

About Field & Fork Network and Double Up Food Bucks

In 2013, F&FN began a partnership with Fair Food Network, a national nonprofit that pioneers solutions that increase access to healthy food--especially in our most underserved communities. The DUFB program makes it easier for low-income individuals and families to eat more fresh fruits and vegetables while supporting farmers and growing local economies. The program is a national model for healthy food incentive programs that provides those who receive Supplemental Nutrition Assistance Program (SNAP) benefits with a $1-to-$1 match that encourages the purchase of healthy, locally grown fruits and vegetables. F&FN's signature program, Double Up Food Bucks, piloted in 2014 at 7 market sites and has since expanded to include over 100 unique participating sites statewide.

Retail Sites are required to do the following if selected to participate in DUFB for the 2021 season:

Attend an in-person or webinar training

Offer and distribute DUFB to SNAP customers at the point of sale

Provide F&FN with third party verification of SNAP sales (e.g. copies of batch reports or monthly statements)

Promote DUFB and SNAP on-site and in the local community

Complete all DUFB reporting requirements, including monthly updates, on the assigned due dates

Administer and participate in all program evaluation, including customer and staff surveys. You will be required to submit a number of surveys that is specific to the volume of your store

Ensure adequate capacity to operate the program and cover any associated administrative costs

Seasonal locations will attend a mid-season call with F&FN and other similar vendors

Year-round locations will attend quarterly check-in calls with F&FN and other similar vendors

Question Title

* 1. Contact Information and Store Info

Name and Title *

Store Name *

Physical Address *

Address 2

City/Town *

State *

ZIP/Postal Code *

County *

Email Address *

Phone Number *

Question Title

* 2. Additional Contact Information

Name and Title *

Email Address

Phone Number *

Question Title

* 3. Website

Question Title

* 4. How did you hear about Double Up Food Bucks?

Another store

Field & Fork Network's website

Another state program

A Double Up Food Bucks flyer

Social Media

A customer

A community organization

Word of mouth

Other (please specify)

Question Title

* 5. Does your store accept or plan to accept Supplemental Nutrition Assistance Program (SNAP)?

Yes

Unsure