Mobile Pantry Scheduling Form Mobile Food Pantry Scheduling Form Agency & Location Information Agency Name * Official version on file with Feeding America West Michigan Agency # * Location Name * May be same as or different from Agency Name; this field will be publicly available to direct people to your distribution Street Address * City * Zip * County * AlconaAlgerAlleganAlpenaAntrimArenacBaragaBarryBayBenzieBerrienBranchCalhounCassCharlevoixCheboyganChippewaClareClintonCrawfordDeltaDickinsonEatonEmmetGeneseeGladwinGogebicGrand TraverseGratiotHillsdaleHoughtonHuronInghamIoniaIoscoIronIsabellaJacksonKalamazooKalkaskaKentKeweenawLakeLapeerLeelanauLenaweeLivingstonLuceMackinacMacombManisteeMarquetteMasonMecostaMenomineeMidlandMissaukeeMonroeMontcalmMontmorencyMuskegonNewaygoOaklandOceanaOgemawOntonagonOsceolaOscodaOtsegoOttawaPresque IsleRoscommonSaginawSt. ClairSt. JosephSanilacSchoolcraftShiawasseeTuscolaVan BurenWashtenawWayneWexford Location Time Zone * Eastern Central Special Location Notes We recommend visiting the Find Food page on our website – www.feedwm.org/FindFood – to check that the automatically generated map of your location is correct. Please use this field to let us know of any needed corrections as well as any special information our driver may need about which driveway to use, which part of the parking lot to go to, etc. Date, Time & Method Selection Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Requested Date plus1 Add More Dates minus1 Remove Last Date Number of Requested Distributions * In past years we have asked partners to commit to hosting at least four distributions in a calendar year, in regular intervals. This is no longer a request, rather a requirement. Single distributions, distributions consolidated around a single season, or distributions at multiple locations without consistency will not be approved, as this does not give the consistent level of service and care to our clients that we wish to provide. Requested time * Available start times are Mon-Fri 9am to 6pm, Sat 9am, 10 am, 1 pm or 2pm only. Mobile pantry distributions outside of Kent County cannot be scheduled before 10:00am. Method of distribution * Walk Up Drive Thru Distribution Size Distribution Size * 50-75 families 75-110 families 110-160 families 160-230 families 230-350 families >350 families (a member of the food bank’s staff will reach out for further details) Partnerships Are you willing to work with other organizations that host Mobile Food Pantries? * Yes No Do you have any interest in providing other resources and/or services for neighbors who visit your Mobile Food Pantries? * Yes No Financial Commitment Please provide your organization’s Mobile pledge commitment for 2026. Note that the development team will not be sending a separate pledge commitment form this year. * Contact Information Contact Person * Contact Phone # (must be a cell phone) * Contact Email Address * Menu Email Address * Secondary Email Address Additional Information Please provide any additional information regarding your answers and the Mobile Pantry program in the box below. If you are human, leave this field blank.
