1. Monthly Agency Statistics Survey

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* 2. What month are you reporting?

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* 3. What type of food program?

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* 4. Name of the person completing the survey

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* 5. For meal programs, how many total meals (# of people served at each meal) were served this month?

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* 6. What is the total number of people served MEALS for the first time this year?

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* 7. For Snack Programs, how many total snacks did you serve to each person this month (# of people multiplied by the number of times you served a snack)?

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* 8. What is the total number of people served SNACKS this month for the first time this year?

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* 9. For pantry programs, what is the total number of households served this month?

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* 10. What is the total number of people served at your PANTRY this month for the first time this year?

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* 11. How many pounds were donated to your organization this month?
(Rule of thumb: 1 item = 1 pound)

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* 12. How many pounds did you purchase at retail/wholesale stores this month?
(Rule of thumb: 1 item = 1 pound)

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* 13. What Client Success Stories have you had this month?

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* 14. Comments/Questions/Concerns?

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