Agency partners

Apply to partner with us

Tell us about your organization. Once you apply, our team reviews it and reaches out about next steps — a New Agency Orientation and a site inspection.

Agency name *Doing Business As (DBA) Federal EIN Website Physical address (for site inspection) City State Zip County Food program phone # Mailing address (if different) Mailing city Mailing state Mailing zip

Other services you provide (and how often)

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Main contact name & title Main contact email *Main contact phone Highest authority (CEO/Pastor) name & title Highest authority email Highest authority phone Monthly reporting contact name Reporting contact email Reporting contact phone

President / CEO name President / CEO email Vice-President name Vice-President email Secretary name Secretary email Treasurer name Treasurer email Other member name + title Other member email

We currently run a food program We assist areas outside our county

How often do you distribute? Hours of distribution Days you serve / cities you serve Cities you serve Avg households served / month Avg individuals served / month Primary population you serve % of clients who are low-income

How do you determine client need?

We currently pick up food from a supplier We would like to pick up food from DBDC

Food storage location Other storage address (if any)

We have a working refrigerator and freezer Our dry storage is secure, locked, and climate-controlled We practice First In, First Out (FIFO)

We collect (or plan to collect) donations from constituents

If yes, please explain When was your last fundraiser?

How will you raise money for your food program?

Standard Community Supporter
Weekly pickups, quarterly impact reports, co-branded social features.Preferred Community Supporter
All Standard, plus website recognition, monthly data, a newsletter feature.Premier Community Supporter
All Preferred, plus host a co-branded event, network access, a strategic review.

Upload PDFs or photos. You can also email documents later, but applications are processed faster when complete.

501(c)(3) Letter of DeterminationEIN Verification (if not on the 501c3 letter)Letter of Recommendation #1Letter of Recommendation #2Safe Food Handling CertificateBlank Client Intake Form (if any)Inspection / Certificate of Operation (if any)

By signing, you affirm the information is true and agree to DBDC's partnership terms: a 3-month probationary period, monthly distribution logs by the 5th, keeping your monthly contribution current, never selling/bartering food, passing an annual site inspection, and serving the needy directly.

I have read and agree to the partnership terms above.

Signer name Signer title Date

Signature

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