Application Instructions s1

Application Instructions Thank you for expressing interest in partnering with the Greater Cleveland Food Bank. Our mission is to ensure that everyone in our communities has the nutritious food they need every day.

Please read the General and Storage Requirements/Guidelines for Becoming a Food Bank Agency to determine if your organization meets the criteria for membership and can operate within the guidelines and polices of the Greater Cleveland Food Bank. If you have any questions regarding these guidelines, please call Agency Services at 216-738- 2133.

All organizations need to fill out Section I of the application, and then proceed to the section that describes the type of program you operate or want to establish. Our membership priorities for 2012 are Emergency Feeding Programs. Applications for Group Homes will not be accepted. The Director/Administrator/Pastor will need to sign the application. Please use the checklist below to make sure you have included all the information to make your application packet complete and then mail or fax the information to:

Agency Services / Jessica Morgan Greater Cleveland Food Bank, Inc. 15500 South Waterloo Road Cleveland OH 44110 Fax: 216.738.1600

Checklist for submitting a complete application:  Copy of the 501©3 IRS determination letter This is not your tax exempt I.D. number, but a letter from the IRS stating that you are a charitable, non-profit organization.  Letter of Interest Please provide a letter of interest on your organization’s letterhead that includes the following: brief description of the program you operate or plan to operate including the “who, what, where, why and how” information, and also include information on how the program will be funded.  A list of Board of Directors names, addresses and telephone numbers  Completed and signed application form

All above items must be included with your application! After reviewing your application and determining the level of need in your geographic area for your program type, we will contact you to make an appointment to visit your agency or to suggest partnering with an existing program. The purpose of the site visit is to confirm the program information you have provided, look at the food storage/food preparation areas and to meet with you and answer any questions you may have. You will be required to attend an orientation session, an online ordering training, and a safe food handling class before you become a member agency. These classes are offered the first Friday of the month at the Greater Cleveland Food Bank.

Applications will not be processed until all information has been submitted. The process to become an agency may take 4-6 weeks. If you have any questions, please call the Agency Services Department at (216) 738-2133. We look forward to a great partnership!

APPLICATION FOR MEMBERSHIP

Section I: General Information

Organization Name: ______

Site Address: ______Street Address City Zip County

Mailing Address______Street Address City Zip

Phone Number: ______Fax Number: ______

Email Address: ______(Please note: Your agency MUST have the capabilities to use a computer and place your orders online to be considered for membership. Pantry Programs MUST use an internet based client intake system. )

Is your organization an affiliate of another organization? ( ) Yes ( ) No

If yes, name of umbrella / parent organization______(Parent organization is programmatically, legally and fiscally responsible for the operation and liabilities of your program)

Sources of Funding: Donations______% Grants/Foundations______% Fundraising Events______%;

Other______% Explain ongoing funding plan: ______

Number of volunteers involved in program(s): ______

Sources of food: %Purchased ______%Donated ______

Geographic service boundaries (if any):______

Client restrictions (if any): ______

How does/will your organization screen clients for eligibility? Describe your intake process, attach sample screening/intake forms if in use: ______

2 Does your organization require income verification and/or client identification? Please explain ______

Do you/will you charge a fee or require clients to work/volunteer in order to receive services? ( ) Yes ( ) No

If yes, describe fee/work requirement system: ______

Do you have adequate transportation to pick up product from Foodbank? ( ) Yes ( ) No ( ) N/A Do you have adequate volunteers to unload a delivery from the Foodbank? ( ) Yes ( ) No ( ) N/A

Do you have regular pest control? If Yes, please provide company name: ______If No, please state the method you use to control pest/rodent problems: ______Section II: Pantry Programs (Complete this section only if your agency distributes bags/boxes of food)

Date current food program began or anticipated start date: ______

Days/hours of food program distribution: ______

How many households are served (anticipate to be served) monthly: ______Individuals: ______

How many days worth of food do/will you provide? ______

Is/will your pantry be open for emergencies? ( ) Yes ( ) No

How often may clients receive food? ______

Is the food storage area secure and locked? ( ) Yes ( ) No

Describe dry storage area (size, shelves, cabinets, pallets, basement area, etc):

______

Indicate how many refrigerators and freezers your agency has:

______Residential refrigerators ______Upright freezers

______Commercial refrigerators ______Chest freezers

______Commercial freezers

Do you have thermometers in: ( ) Dry storage area ( ) Refrigerators ( ) Freezers Do you currently keep temperature logs? ( ) Yes ( ) No

Program Contact Name: ______

Phone (H): ______(W): ______

E-mail address: ______

Dir./Administrator/Pastor (if different than above)______

3 Phone: ______

Email address: ______

Authorized people to place food orders at the Foodbank: 1. Name:______Phone: ______2. Name:______Phone: ______3. Name:______Phone: ______Authorized people to pick up food orders at the Foodbank (if different) 1. Name:______Phone: ______2: Name:______Phone: ______3. Name:______Phone: ______

Section III: On-Site Meal Providers (Complete this section only if clients eat meals or snacks at your location)

Date current meal program began or anticipated start date: ______

What type of program (kitchen, shelter, children’s program etc.): ______

Days/hours of feeding program operation: ______

How many meals are served:

Breakfast: ______Daily ______Weekly ______Monthly

Lunch: ______Daily ______Weekly ______Monthly

Snacks: ______Daily ______Weekly ______Monthly

Dinner: ______Daily ______Weekly ______Monthly

Does your agency prepare meals on-site? ( ) Yes ( ) No Use catered meals? ( )Yes ( ) No

Is your agency licensed and inspected by the Board of Health? ( ) Yes ( )No

If yes, what is your license number: ______

Is the food storage area secure and locked? ( ) Yes ( ) No

Describe dry storage area (size, shelves, cabinets, pallets, basement area, etc): ______

______

Describe kitchen facility: ______

______4 Indicate how many refrigerators and freezers your agency has:

______Residential refrigerators ______Upright freezers ______Commercial refrigerators ______Chest freezers ______Commercial freezers

Do you have thermometers in: ( ) Dry storage area ( ) Refrigerators ( ) Freezers Do you currently keep temperature logs? ( ) Yes ( ) No

Program Contact Name ______

Phone (H): ______(W): ______

E-mail address: ______

Dir./Administrator/Pastor (if different than above) ______

Phone: ______

Authorized people to place food orders at the Foodbank: 1. Name:______Phone: ______2. Name:______Phone: ______3. Name:______Phone: ______

Authorized people to pick up food orders at the Foodbank (if different) 1. Name:______Phone: ______2. Name:______Phone: ______3. Name:______Phone: ______

Any other pertinent information: ______

______

To the best of my knowledge the above information is correct.

______

5 Application completed by (please print): Date

______Signature of Director/Administrator/Pastor Date

Please Note: completion of this application does not guarantee membership. We reserve the right to refuse membership to agencies not meeting our criteria and/or not aligning with our current intake prioritization.

General Requirements/Guidelines for Becoming a Food Bank Agency

 Must operate a feeding program that directly serves the needy, ill, infants/children and the elderly, and use the Food Bank product only in a manner related to its tax-exempt purpose.

 Your organization must be located in an area of need. The Food Bank reserves the right to review the concentration of existing programs in your neighborhood and may make a recommendation to partner with an existing program.

 Agencies can not operate any part of the food program out of a home. All food must be stored, prepared and distributed at a site approved by the Food Bank.

 In accordance with Federal Law and the U.S. Department of Agriculture policy, agencies are prohibited from discriminating on the basis of race, creed, color, national origin, gender, sexual orientation, religious affiliation or lack thereof, age, disability or any other characteristic that is protected by law.

6  Cannot require a fee for meals or pantry bags of food. All products must be distributed at no charge, with no suggested or implied donation amount or volunteer requirement.

 Cannot require participation or attendance in religious service, ministry, or class of any kind in order to receive food or a meal.

 Must have the capabilities to use a computer and place orders online.

 If applying to become a pantry program, must have the ability to use an internet-based client intake system (requires internet capabilities and computer on-site).

 Food Bank product must only be distributed / used for the approved program’s clients, it must not be distributed to another agency, group or organization or used for any other purpose (ex: fundraisers, block parties, funeral meals).

 Must maintain regular, published hours of operation.

 Must maintain a filing system for paperwork that includes Food Bank invoices, monthly statistical reports, and client income eligibility forms (if applicable). All paperwork must be kept for 3 years, and made available upon request.

 Must be willing to provide the Food Bank with regular service statistics by submitting a monthly statistical report by the 5th working day of every month that summarizes how many people were served during the previous month.

 Must allow site-visits, sometimes without prior notification.

 The member agency must be financially viable with provisions in place for on-going financial support of the Food Bank program.

Storage Requirements/Guidelines

 Must have adequate storage space and refrigeration at the site of the distribution to ensure the integrity of the product until it is prepared or distributed. It is the Food Bank’s expectation that agencies have the ability to store and distribute highly nutritious fresh produce and other perishable product.

 All food products must be stored according to safe food handling procedures. Dry products must be 6 ” off the floor and 18 ” from the ceiling, pallets and shelving may be used. This also includes walk-in coolers and freezers. Non-food items must be stored separately from food.

7  Must maintain appliances at proper temperatures and have thermometers in each storage area. Temperature logs must be kept for the refrigerator, freezer and dry storage area to ensure proper storage. All appliances must be located at distribution site.