Become a Partner Agency Name* Contact Name* First Last Email* Phone*Is your organization registered as a 501c3?* Yes No 501c3 Number* (please include current verification from IRS website below)If not a 501c3 organization, are you sponsored by a church or other religious organization? If so, which one? Please provide contact name and information for pastor or church member to verify connection.*Type of program(s) currently offered? (food pantry, soup kitchen, backpack program, etc.) How long has the program(s) been in operation?* Number of households/individuals served each month* Number of volunteers/staff each day* Hours of operation*Physical address where food is distributed* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary source of support (congregation budget, community donations, grants, fundraisers, etc.)* Annual budget Does your organization have the ability to use a computer for online ordering and reporting?* Please write a brief paragraph explaining your agency's mission, outreach and why you would like to partner with the South Michigan Food Bank*CAPTCHACommentsThis field is for validation purposes and should be left unchanged.
