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Partner Agency Screening

The Process

Complete this form as a preliminary step of the Partner Agency application process. Please be sure to attach the requested documents.

The following documents will be requested:
  1. 501(c)(3) IRS Letter of Determination, updated with current agency/organization address and information
    • If the food program is not the holder of the 501(c)(3) status, a signed letter from the organization holding the 501(c)(3) confirming they are sponsoring the food program
  2. Certified Kitchen License
  3. Food program mission statement
  4. Food program budget
  5. A list of the Board Members/Advisory Board members and their contact information
Screening forms will be reviewed on a monthly basis. Please allow proper time for review before we contact you in regards to your status.

Based on your screening, you may be invited to complete a full application, at which point the NEIFB will invoice you for the $125 non-refundable application fee. Personal checks and cash are not accepted. Payment MUST be a check from the sponsoring organization or named program. Applications will not be reviewed until the application fee has been received.

Agency applications will be reviewed on a biannual basis as detailed below. If you are invited to complete a full application, the month in which the completed application and application fee is received will determine when the application review, approval and training will take place.



For example:
  • The Screening Form is completed July 12 with documents and the Application submitted August 3. review, approval and training will be in September with the first partnership month as October.
  • The Screening Form completed August 3 with documents and the Application submitted on September 1. The review, approval and training will be in March.
We will contact you once the review and approval process have been completed.
1.Initial below to confirm your acknowledgement of this process and timeline.(Required.)
2.Please provide the following information about you:(Required.)
3.Please provide the following information about the sponsoring organization:(Required.)
4.Does the Food Program have the same name, address and contact information as the Sponsoring Organization?(Required.)
5.If different from the Agency/Organization, please provide the information for the Food Program.
6.What type of food program are you applying for NEIFB Partnership? Select all that apply.(Required.)
7.Is the food program your main program and purpose of why your organization was formed?(Required.)
8.Why did you begin your food program?(Required.)
9.How long has the food program been operating?(Required.)
10.Are you participating in the Child and Adult Care Food Program (CACFP)?(Required.)
11.How do clients use food provided by your food program? Select all that apply.(Required.)
12.Are 51% or more of those you serve food insecure?(Required.)
13.How many housesholds do you serve each month?
14.Please describe the process the food program uses to determine that the majority of the people you serve is food insecure.(Required.)
15.Does your food program or agency have a 501c3 status? If you are unsure, please visit the IRS.gov website https://apps.irs.gov/app/eos/ to check.(Required.)
16.What is the food program or sponsoring organization's 501c3 number?(Required.)
17.You are required to send the 501(c)(3) IRS Letter of Determination. It must be updated with current agency/organization address and information. If the food program is not the holder of the 501(c)(3) status, a signed letter from the organization holding the 501(c)(3) confirming they are sponsoring the food program is required. ATTACH DOCUMENT.
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18.Does your agency have an executive director, president, or other designated leader position?(Required.)
19.Does your agency have a formal Board of Directors/Advisory Board?(Required.)
20.Please provide a list of the Board Members/Advisory Board and the members' contact information(Required.)
21.Please attach the list of your Board Members/Advisory Council and their contact information. ATTACH DOCUMENT.
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22.If this is a congregate meal (serving meals more than once a week), do you have a licensed kitchen* (such as a church, school, or daycare)?

*A licensed kitchen is a special cooking space that has permission from the government to make food for others. It follows safety rules to keep the food clean and safe to eat.(Required.)
23.Please attach your Certified Kitchen License if applicable. ATTACH DOCUMENT.
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What is a Mission Statement?
24.Do you have a food program mission statement?(Required.)
25.Attach the copy of the food program's mission statement. ATTACH DOCUMENT.
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Below is a sample budget
26.Do you have a food program budget?(Required.)
27.Please attach the full food program budget to this Screening form. ATTACH DOCUMENT.
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28.Below you will see a table of Partner Agency Requirements. Indicate which type meal program you operate based on the below requirements.(Required.)
29.Is there anything else you'd like to share with us in regards to your interest in becoming a partner with the NEIFB?