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Agency Information Update Form
Agency Name
Agency Number
Phone Number for Client Services
Extension
Agency Contact Information
For internal use only.
Agency Contact Information
Agency Contact Information
Name
Email
Phone
Item weight
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Hours of Operation
Authorized Product Selector(s)
These are the only persons allowed to recieve product from HHFB with a scheduled appointment.
Authorized Product Selector(s)
Authorized Product Selector(s)
Name
Email
Phone
Item weight
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more items
Warning message
If at any time Harvest Hope attempts to contact your organization and any of the information listed above is incorrect, your organization will be placed "inactive" until contact can be made, which in turn may also warrant an unannounced site visit.
If the information on this form changes, you
MUST
fill out this update form. Unlisted contact persons and/or hoppers will not have access to the food bank until this form is completed
Signature
Sign below using mouse, touchpad, or touchscreen.
Name of Signee
Signature Date
Leave this field blank
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