Food Bank Name:

Principal Contact:

Mobile Tel No:

e-mail:

Areas Covered:

On Average how many families have received food parcels each week in the last 4 weeks:

How many people within those families:

Is the number of people asking for food parcels currently:
IncreasingDecreasingStable

Are food donations increasing or decreasing over the last 12 months:
IncreasingDecreasingStable

Are cash donations increasing or decreasing over the last 12 months:
IncreasingDecreasingStable

On average how much are you spending on food each month:

Where do you buy food from:

Do you have to buy food most weeks to top up parcels:
YesNo

How many volunteers do you have:

Do you deliver food parcels:
YesNoSome

For how long do you provide food parcels to a family:

Do you ask families to be refferred to you:
YesNo

Where do your referrals come from:

What are the main reasons that families are using food banks:

What percentage of families that you help are working:

Please provide an age breakdown as a percentage for the people you help:

Under 20 20 -30 30 - 50 50 - 65 Pensioners

What other areas of help do you provide:
BudgetingUtiliies ManagementWarm HubCooking LessonsSchool UniformMoneyGift VouchersChristmas Hampers

Any other comments:

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