How to Develop a Food Pantry Intake Form

by Crystal Buckle

Food pantries are available to low-income families in several communities; they provide basic foods, such as cereals and canned foods, on a weekly or monthly basis. Most food pantries are nonprofit organizations that rely on the donations they receive from people or business corporations, and on people in the community who work for the organization as volunteers. To keep track of the amount of families that participate in the food pantry programs, organizations need to have intake forms. Intake forms include information that is used to contact the participating families and keep track of the amount of times the families received food from the organization.

Include a title. The title should be a short and simple. Include the name of the program and form, such as "Bright Circle Food Pantry Intake Form."

Put directions on the intake form. Inform the readers as to what they are filling out and why their personal information is required. An example is, "Please properly fill out this form so we can better accommodate you. Any information listed is used by Bright Circle Food Pantry for contact information and reporting purposes, it is not used to supply information to any other organization." Providing instructions to the applicant gives him a basic comprehension of the form.

Provide a section for the applicant to provide contact information, such as a name, address, phone number and email address. Contact information is used to mail forms or newsletters and call for appointment reminders or follow-ups.

Include a section for the applicant to provide general information regarding the household, such as the number of people currently living in the household, as well as the number of children, adults, and elderly living in the household. Knowing the household size is important because it helps determine the amount of food needed and gives a general idea of the applicant's monthly expenses.

Provide a section for the applicant to provide information about other programs he is a participant of, such as state food assistance or other food pantries. This information is important in case your program only accepts applicants that are not participants of other programs and it helps determine the amount of food needed as well.

Develop a section for the applicant to provide information regarding the amount of assistance he received from your program. It is important for your program to include this information, especially if there is a certain amount of times an applicant is allowed to receive assistance from your program.

Allow the applicant to provide monthly income information the household receives such as the type of income (disability, unemployment, earned) and the amount received monthly per person. When using the income to determine the amount of food needed consider the size of the household as well.

Make room for the applicant to provide any other basic needs he has such as clothing or shelter. In case your program supplies applicants with referrals, this information can be useful because it gives a general idea of where to refer the client and how much assistance he needs.

Provide a signature and date line. A signature verifies the information provided is correct to the best of the applicant's knowledge and was in fact completed by the applicant.

About the Author

Crystal Buckle has written professionally since 2010. She brings a great amount of health-care knowledge to her articles for various websites. Buckle is pursuing a Bachelor of Arts at Marygrove College.

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