PANTRY MONTHLY NUMBERS FORM

Every pantry/program within the SCHTF network is required to submit Monthly Numbers. The report must be submitted to the SCHTF by the 10th of each month which includes the previous month’s report. Even if your pantry/program was not operating within the previous month, submit a report with “0”s for that month. Pantries/programs that do not submit monthly numbers are subject to consequences.

Thank you for your time, kind hearts and dedication to fighting hunger in Stark County.

Pantry Number*
Pantry Name*
Month You Are Reporting For*
Name of Person Reporting (First and Last)*
Phone*
Email*
HOUSEHOLDS
Number of households WITH children*
Number of households WITHOUT children*
TOTAL number of households*
SENIORS
Number of seniors served (age 60 & older) in households WITH children*
Number of seniors served (age 60 & older) in households WITHOUT children*
TOTAL number of seniors served (age 60 & older)*
ADULTS
Number of adults served (age 18-59) in households WITH children*
Number of adults served (age 18-59) in households WITHOUT children*
TOTAL number of adults served (age 18-59)*
CHILDREN
Number of children served (birth - 17)*
TOTAL SERVED
TOTAL number of people served in households WITH children*
TOTAL number of people served in households WITHOUT children*
CONTACT INFORMATION
If any of your information (address, phone number, pantry point of contact) has changed since your last entry, please enter it below.

HOUSEHOLDS

SENIORS

ADULTS

CHILDREN

TOTAL SERVED

CONTACT INFORMATION