PANTRY MONTHLY NUMBERS FORM

Every pantry and program within our network is required to submit their monthly numbers. Your numbers for each month must be submitted via this form by the 10th of the following month. If your pantry or program was not operating within the previous month, submit a report with zeroes for that month. Pantries and programs that do not submit monthly numbers are subject to consequences. Thank you for your time and dedication to fighting hunger in Stark County!

Pantry Number*
Pantry Name*
Which city is your pantry located in?*
Month You Are Reporting For*
Name of Person Reporting (First & 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.
Questions or concerns:

HOUSEHOLDS

SENIORS

ADULTS

CHILDREN

TOTAL SERVED

CONTACT INFORMATION