Edible Food Donated

Name of Business

Date 

Phone Number

Email

Please Select Each Type of Food Collected by Food Recovery Organizations (Multiple May Be Selected) Please Select Each Type of Food Collected by Food Recovery Organizations (Multiple May Be Selected) Vegetative Meat Eggs/Dairy/Dairy Alternative Cooked/Baked/Prepared Perishable Items Packaged Non-Perishable Items

Please Select The Food Recovery Organization(s) That Collect Edible Food. (Multiple May Be Selected) Please Select The Food Recovery Organization(s) That Collect Edible Food. (Multiple May Be Selected) Corning Christian Assistance/Corning Senior Center Food for the Hungry Rancho Tehama Community Church Salt Ranch Tehama County Gleaners Seventh-day Adventist Community Services Cornerstone Church of God Spirit of Life Church P.A.T.H Salvation Army Empower Tehama High Point Assembly Immaculate Conception Church New Life Assembly Other

How Often Is Food Collected? (i.e. Once per Week, Monday/Wednesday/Friday, etc.)

Pounds of Edible Food Donated to Food Recovery Organizations From January - December. Please round to the nearest pound.

Additional Information (Optional)