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Resources Questionnaire
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* Indicates required question
Company Name
*
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Contact Name
*
Your answer
Contact Email
*
Your answer
Contact Phone
*
Your answer
Company Website
Your answer
Which of the following goods and/or services are you able to provide?
*
Prepared ready-to-eat meals (no heating required)
Prepared meals (heat and serve)
Perishable food items (e.g. produce, meats, dairy foods)
Non-perishable (shelf-stable) food items
Specialty foods (e.g. vegan/vegetarian, kosher, gluten-free, low sodium, low carbs/sugar)
Food delivery
Other:
Required
Are you selling or donating your services?
Selling
Donating
Both
Clear selection
If both, please specify services you are selling vs. donating.
Your answer
Would you be willing and able to serve as a coordinator for other, similar organizations?
Yes
No
Maybe
Clear selection
Next
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