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Redistribution Community Partner Request Form

Home / Redistribution Community Partner Request Form

Redistribution Community Partner Request Form

Please fill out this form to request specific items for the following week (Mon–Fri). If you have any questions or issues with this form, please contact The River's Community Coordinator, Amanda Prusak, at 608-665-0232 or amanda@riverfoodpantry.org.

Your Information

Name:(Required)

Email:(Required)

Phone:(Required)

Organization/Agency:(Required)

This Week's Distribution

If you have served/distributed product from The River this week, please use this space to report individuals and/or households served.

Number of Individuals

Total number of individuals who received product from The River through your organization this week

Number of Households

Total number of households who received product from The River through your organization this week. If you do not record households served, leave blank.

Needs for Week Ahead

Please share the products you hope to receive next week, as well as quantities when possible. Feel free to be specific in your requests, but know that The River will not necessarily be able to offer exactly what you request. When we do not have exact matches in stock, we will do our best to find a close substitute.

Number of Individuals you expect to serve(Required)

Do you need any fruits or vegetables?(Required)

Yes

No

Fruits and Vegetables Requested

Do you need dairy products, eggs, or butter?(Required)

Yes

No

Dairy products, eggs requested:

Do you need bakery items?(Required)

Yes

No

Bakery Items Requested:

Do you need prepared/ready to eat foods (microwavable meals, sandwiches, salads, etc.)?(Required)

Yes

No

Ready to Eat Foods Requested:

Do you need shelf-stable food items?(Required)

Yes

No

Shelf-stable Items Requested:

Do you need non-food items (clothing, housewares, personal hygiene, etc.)?(Required)

Yes

No

Non-Food Items Requested:

Please list the date and time for your request:(Required)

If this is a delivery, write delivery in the box.

Thank you!

Please click "submit" to enter your information. Amanda will receive an email with your responses and will try to get every item requested.

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The River Food Pantry

The River Food Pantry
2201 Darwin Rd.
Madison, WI 53704

info@riverfoodpantry.org

The River Food Pantry is a 501(c)(3) nonprofit organization | EIN: 20-4179749 | This institution is an Equal Opportunity/Affirmative Action Employer.

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