Monthly Report

Please submit your end of month totals for the account number you are reporting.  Some partners have several programs, so please submit a separate report for each account number.  If you are not sure what your account number(s) are by program, please call us at 480-291-3237. 

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* 1. Agency Name & Account Number

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* 2. Please indicate the type of distribution below for the account number listed above:  (Please note, TEFAP and CSFP sites please utilize your TEFAP MIPR and CSFP MIR forms to report for boxes distributed)

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* 5. Total number of households served this month

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* 6. Total number of individuals (living within those households)

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* 7. Please indicate the total number of unduplicated households served this month.  (This number reflects the total number of clients who visited your pantry only one time this month)

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* 8. Total number of children served (0-18yrs)

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* 9. Total number of children served (0-5yrs)

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* 10. For meal providers: Please provide the total number of meals provided this month

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* 11. For snack providers: Please provide the total number of snacks provided this month

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* 12. Please provide the approximate poundage received from sources other than SMFBA (Grocery Rescue participants please DO NOT include that poundage since it is recorded in Meal Connect). This statistical data will be used to review area poverty levels vs. poundage being provided so we may better reflect the amount of food assistance being distributed in your county.

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* 13. Not all product makes it to our clients, help us evaluate how much poundage actually is being used by clients by letting us know the estimated number of pounds your agency had to throw away this month.

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* 14. Did you receive enough food from SMFBA this month?

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* 15. Has a SMFBA staff or driver provided you with exemplary service this month? Have you encountered an issue this month that you want documented or addressed?  If you would like to recognize a staff person or let us know of an issue please type it in below:

Thank you for submitting your monthly report.  If you have any questions or need to contact Agency Services, please call 480-393-5166 or email agencyservices@firstfoodbank.org

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