{"id":4574,"date":"2016-06-08T14:49:46","date_gmt":"2016-06-08T18:49:46","guid":{"rendered":"https:\/\/gcfbportal.wpengine.com\/agency\/?page_id=4574"},"modified":"2024-01-09T14:13:12","modified_gmt":"2024-01-09T19:13:12","slug":"application-for-partnership","status":"publish","type":"page","link":"https:\/\/portal.clevelandfoodbank.org\/agency\/application-for-partnership\/","title":{"rendered":"Application for Partnership"},"content":{"rendered":"\n\n<script type=\"text\/javascript\">var 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gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_1\"><p>Thank you for expressing interest in partnering with the Greater Cleveland Food Bank! Our mission is to ensure that everyone in our communities has the nutritious food they need every day. Our service area includes Cuyahoga, Lake, Geauga, Ashland, Ashtabula, and Richland counties.<\/p>\n\n<p>Applications will not be processed until all information has been submitted. The process to become a member agency may take 4-6 weeks.  If an application is submitted October - December, you will receive a follow up response in January. Partnership is year round and we are unable to support food donations for one time special events, annual programs or distributions for organizations that are not partners i.e. Thanksgiving turkey drives, basket giveaways etc. If you have any questions, please call the Agency Services Department at (216) 738-2068. We look forward to a great partnership! <\/p>\n\n<p>Please read the General Guidelines and Storage Requirements for becoming a Food Bank Partner Agency to determine if your organization meets the criteria for membership and can operate within the guidelines and policies of the Greater Cleveland Food Bank. If you have any questions regarding these guidelines, please call Agency Services at 216-738-2068.<\/p>\n\n<p>All organizations need to complete our application online in order to be considered for membership.   Our membership priorities are Food Pantries that have the capability to serve their community at least twice per month, providing food to a minimum of 100 households per month, and\/or are located in an underserved area. Communities we would like to expand to based on the largest people gaps for communities that qualify for our services, but do not receive them include: Ashland County: NW portion of the county \u2013 Clear Creek, Ruggles, Orange, Troy\nAshtabula County: Windsor, Cherry Valley, Dorset, Geneva, Hartsgrove, Morgan, Richmond, Rome, and Trumbull\nCuyahoga County:  Parts of the Cleveland Neighborhoods: Bellaire-Puritas, Brooklyn Center, Cudell, Edgewater, Jefferson, North Shore Collinwood, and Old Brooklyn, as well as in  portions of the suburbs (Berea, Euclid, Fairview Park, Glenwillow, Lakewood, Mayfield Heights, North Olmsted, North Royalton, Parma, Parma Heights, Oakwood, and Strongsville).\nGeauga County: Burton, Chesterland, Huntsburg, Middlefield, and Parkman\nLake County: Madison Township, Mentor, Mentor-on-the-Lake, North Madison, Painesville and Willoughby Hills\nRichland County: Lexington, Madison, Mansfield, Ontario, Shelby, and Troy. \n \n\n<p>Applications for Food Pantries or Hot Meals will not be accepted if the Food Pantry or Hot Meal has been operating for less than 6 months.  Applications for Residential Programs will not be accepted if the agency has been operating for less than 1 year, and\/or serves less than 15 residents per agency site. Please use the checklist below to make sure you have included all the information to make your application packet complete.<\/p>\n\n<p>Checklist for submitting a complete application: <p>&#61692; Copy of the 501c3 IRS determination letter. This is not your tax exempt I.D. number, but a letter from the IRS stating that you are a charitable, non-profit organization. <p> &#61692; Please provide a letter of interest on your organization's letterhead that includes the following: brief description of the program you operate  including the \"who, what, when, where, why and how\" information, and also include information on how the program will be funded. <p>&#61692; A list of Board of Directors names, addresses and telephone numbers.<\/p>\n\n<p>&#61692; Pantry or Hot Meal's 6 Months of Operation Documents (examples may include: 6 months of distribution sign-in sheets, 6 months of food receipts, or 6 months of volunteer work schedules).<\/p>\n\n<p>&#61692; If applying to become a Meal provider program, at least one person during service must have an advanced food safety certification. Either \"ServSafe Manager\" level or equivalent, or certified in \"Food Protection\" with the Ohio Department of Health.<\/p>\n\n<p>All above items must be included with your application. After reviewing your application and determining the level of need in your geographic area for your program type, we will contact you to make an appointment to visit your agency or to suggest partnering with an existing program. The purpose of the site visit is to confirm the program information you have provided, look at the food storage\/food preparation areas, and to meet with you and answer any questions you may have. You will be required to attend an orientation session, an online ordering training, and a basic safe food handling class before you become a member agency. These classes are offered about every 6-8 weeks.  We do not hold orientation classes during November and December.  <\/p>\n\n<\/li><li id=\"field_85_126\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_126\"><h2 class=\"gsection_title\" id=\"general-requirements-guidelines-for-becoming-a-food-bank-partner-agency\" >General Requirements\/Guidelines for Becoming a Food Bank Partner Agency<\/h2><\/li><li id=\"field_85_125\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_125\"><p>&#61664; The organization must maintain a 501(c)3 status as determined by the IRS.<\/p>\n\n<p>&#61664; Must operate a feeding program that directly serves the needy, ill, infants\/children and the elderly, and use the Food Bank product only in a manner related to its tax-exempt purpose.<\/p>\n\n<p>&#61664; Your organization must be located in an area of need. The Food Bank reserves the right to review the concentration of existing programs in your neighborhood and may make a recommendation to partner with an existing program. <\/p>\n\n<p>&#61664; If applying to be a Food Pantry or Hot Meal, a minimum of 1 food distribution or meal is required a month.  Having more than 1 distribution or meal a month is strongly encouraged.  (Through gap analysis and research, the Food Bank will make recommendations for the best days\/times to have your distributions or meals.)<\/p>\n\n<p>&#61664; Emergency Feeding Partners (Ex. Pantry, Hot Meal, Shelters), serve a minimum of 100 households or meals per month.<\/p>\n\n<p>&#61664; All food must be stored, prepared and distributed at a site approved by the Food Bank. Locations not permitted include a personal residence or storage locker\/unit. <\/p>\n\n<p>&#61664; All Emergency Feeding program partners (Ex. Pantry, Hot Meal, and Shelters), acknowledge that in accordance with Federal laws and USDA policy, we agree we will comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C. \u00a7 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C \u00a71681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. \u00a7 794), the Age Discrimination Act of 1975 (42 U.S.C. \u00a7 6101 et seq.); all provisions required by the implementing regulations of the Department of Agriculture; Department of Justice Enforcement Guidelines, 28 CFR Part 50.3 and 42; and FNS directives and guidelines, to the effect that, no person shall on the grounds of race, color, national origin, political belief, sex including gender identity and sexual orientation, age, or disability, be excluded from participation in, be denied benefits of, or otherwise be subject to discrimination under any program or activity for which the program applicant receives Federal financial assistance from FNS. The member agency agrees to operate the program in accordance with requirements of 7 CFR 247, 250 , and 251 (where applicable), as well as the Food Programs Manual.\n\n<p>&#61664; Cannot require clients to pay a fee for meals or pantry bags of food. All products must be distributed at no charge, with no suggested or implied donation amount.<\/p>\n\n<p>&#61664; Cannot require participation or attendance in religious service, ministry, or class of any kind in order to receive food or a meal.<\/p>\n\n<p> &#61664; Cannot impose volunteer requirements for clients to receive food. In addition, volunteers and\/or staff may access the services provided, but must meet guidelines for service and be served in a manner that is consistent with all other clients. Special treatment for staff\/volunteers is prohibited.<\/p>\n\n<p>&#61664; Must have the capabilities to use a computer and place orders online.<\/p>\n\n<p>&#61664; If applying to become a pantry program, must have the ability to use an internet-based client intake system (requires internet capabilities and computer on-site).<\/p>\n\n<p>&#61664; If applying to become a Meal provider program, must have an advanced food safety certification.  Either \"ServSafe Manager\" level or equivalent, or certified in \"Food Protection\" with the Ohio Department of Health. <\/p>\n\n<p>&#61664; Food Bank product must only be distributed \/ used for the approved program's clients, it must not be distributed or sold to another person, agency, group or organization or used for any other purpose (ex: fundraisers, block parties, funeral meals).<\/p>\n\n<p>&#61664; Must maintain regular, published hours of operation. The Greater Cleveland Food Bank reviews agency service hours regularly and may request or encourage your site to adjust service times based on community need.<\/p>\n\n<p>&#61664; Must maintain a filing system for paperwork that includes Food Bank invoices, monthly statistical reports, and client income eligibility forms (if applicable). All paperwork must be kept for 7 years, and made available upon request.<\/p>\n\n<p>&#61664; Must be willing to provide the Food Bank with regular service statistics by submitting a monthly statistical report by the 5th working day of every month that summarizes how many people were served during the previous month. Monthly stats must be submitted electronically. <\/p>\n\n<p>&#61664; Must allow site-visits, sometimes without prior notification.<\/p>\n\n<p> &#61664; Must have the capacity, willingness, and desire to help distribute nutritious foods, close dated product, and help the Food Bank meet its mission and organizational goals.<\/p>\n\n<p>&#61664; The member agency must be financially viable with provisions in place to sustain agency operations.   \n\n<p> &#61664; Payment to the Food Bank must be drawn from the 501(c)3 agency's checking account.<\/p>\n\n<p><b>Storage Requirements\/Guidelines<\/p><\/b>\n\n<p> &#61664; All Food Bank product must be stored at an approved location. Food storage area should be secure. <\/p>\n\n<p>&#61664; Must have adequate storage space and refrigeration at the site of the distribution to ensure the integrity of the product until it is prepared or distributed. It is the Food Bank's expectation that agencies have the ability to store and distribute highly nutritious fresh produce and other perishable product. Each agency must have at least one refrigerator and one freezer.<\/p>\n\n<p>&#61664; All food products must be stored according to safe food handling procedures. Dry products must be 6\" off the floor and 18\" from the ceiling, pallets and shelving may be used. This also includes walk-in coolers and freezers. Non-food items such as cleaning products must be stored separately from food.<\/p>\n\n<p>&#61664; Must maintain appliances at proper temperatures and have thermometers in each storage area. Temperature logs must be kept for the refrigerator, freezer and dry storage area to ensure proper storage. All appliances must be located at distribution site. <\/p><\/li><li id=\"field_85_94\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_94\"><h2 class=\"gsection_title\" id=\"_\" ><\/h2><\/li><li id=\"field_85_124\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_124\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >I certify that I have read and understand the General Requirements and Guidelines for Becoming a Food Bank Partner Agency.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_85_124'><li class='gchoice gchoice_85_124_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_124.1' type='checkbox'  value='Yes'  id='choice_85_124_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_124_1' id='label_85_124_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_124_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_124.2' type='checkbox'  value='No'  id='choice_85_124_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_124_2' id='label_85_124_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_83\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_83\"><h2 class=\"gsection_title\" id=\"general-information\" >General Information<\/h2><\/li><li id=\"field_85_2\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_2\"><label class='gfield_label gform-field-label' for='input_85_2' >Organization Name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_85_2' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_3\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_3\"><label class='gfield_label gform-field-label' for='input_85_3' >Site Address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_85_3' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_4\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_4\"><label class='gfield_label gform-field-label' for='input_85_4' >City:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_85_4' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_98\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_98\"><label class='gfield_label gform-field-label' for='input_85_98' >Zip:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_98' id='input_85_98' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_99\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_99\"><label class='gfield_label gform-field-label' for='input_85_99' >County:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_99' id='input_85_99' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_5\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_5\"><label class='gfield_label gform-field-label' for='input_85_5' >Program Phone Number:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_85_5' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_138\"  class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_138\"><label class='gfield_label gform-field-label' for='input_85_138' >Email Address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_138' id='input_85_138' type='text' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_85_138\" \/>\n                        <\/div><div class='gfield_description' id='gfield_description_85_138'>Please note: Your agency MUST have the capabilities to use a computer and place your orders online to be considered for membership.  Pantry Programs are required to use an internet based client intake system.<\/div><\/li><li id=\"field_85_100\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_100\"><label class='gfield_label gform-field-label' for='input_85_100' >Statement Email Address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_100' id='input_85_100' type='text' value='' class='medium'  aria-describedby=\"gfield_description_85_100\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_85_100'>Please note: The Greater Cleveland Food Bank emails monthly billing statements to partner agencies. <\/div><\/li><li id=\"field_85_7\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_7\"><label class='gfield_label gform-field-label'  >Is your organization an affiliate of another organization?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_7'>\n\t\t\t<li class='gchoice gchoice_85_7_0'>\n\t\t\t\t<input name='input_7' type='radio' value='Yes'  id='choice_85_7_0'    \/>\n\t\t\t\t<label for='choice_85_7_0' id='label_85_7_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_7_1'>\n\t\t\t\t<input name='input_7' type='radio' value='No'  id='choice_85_7_1'    \/>\n\t\t\t\t<label for='choice_85_7_1' id='label_85_7_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_8\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_8\"><label class='gfield_label gform-field-label' for='input_85_8' >If yes, name of umbrella\/parent organization:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_85_8' type='text' value='' class='medium'  aria-describedby=\"gfield_description_85_8\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_85_8'>(Parent organization is programmatically, legally and fiscally responsible for the operation and liabilities of your program)<\/div><\/li><li id=\"field_85_102\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_102\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >What type of program are you applying to be?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_85_102'><li class='gchoice gchoice_85_102_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_102.1' type='checkbox'  value='Pantry Program (providing at least 3 days supply of food for client to take home for everyone in the household)'  id='choice_85_102_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_102_1' id='label_85_102_1' class='gform-field-label gform-field-label--type-inline'>Pantry Program (providing at least 3 days supply of food for client to take home for everyone in the household)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_102_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_102.2' type='checkbox'  value='On-Site Meal Providers (providing prepared food for the general public to eat meals or snacks at your site i.e. congregate meals, soup kitchens etc.)'  id='choice_85_102_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_102_2' id='label_85_102_2' class='gform-field-label gform-field-label--type-inline'>On-Site Meal Providers (providing prepared food for the general public to eat meals or snacks at your site i.e. congregate meals, soup kitchens etc.)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_102_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_102.3' type='checkbox'  value='Non-Emergency Pantry Program (pantry programs NOT open to the general public)'  id='choice_85_102_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_102_3' id='label_85_102_3' class='gform-field-label gform-field-label--type-inline'>Non-Emergency Pantry Program (pantry programs NOT open to the general public)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_102_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_102.4' type='checkbox'  value='Non-Emergency Meal Providers (meal providers NOT open to the general public providing meal and snack items i.e. closed meal site)'  id='choice_85_102_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_102_4' id='label_85_102_4' class='gform-field-label gform-field-label--type-inline'>Non-Emergency Meal Providers (meal providers NOT open to the general public providing meal and snack items i.e. closed meal site)<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_146\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_146\"><label class='gfield_label gform-field-label'  >Are you a healthcare facility?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_146'>\n\t\t\t<li class='gchoice gchoice_85_146_0'>\n\t\t\t\t<input name='input_146' type='radio' value='No'  id='choice_85_146_0'    \/>\n\t\t\t\t<label for='choice_85_146_0' id='label_85_146_0' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_146_1'>\n\t\t\t\t<input name='input_146' type='radio' value='Yes'  id='choice_85_146_1'    \/>\n\t\t\t\t<label for='choice_85_146_1' id='label_85_146_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_150\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_150\"><label class='gfield_label gform-field-label'  >Do you plan for this pantry to be a Food Clinic, in which patients are provided food prescriptions intended to improve their health outcomes?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_150'>\n\t\t\t<li class='gchoice gchoice_85_150_0'>\n\t\t\t\t<input name='input_150' type='radio' value='Yes'  id='choice_85_150_0'    \/>\n\t\t\t\t<label for='choice_85_150_0' id='label_85_150_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_150_1'>\n\t\t\t\t<input name='input_150' type='radio' value='No'  id='choice_85_150_1'    \/>\n\t\t\t\t<label for='choice_85_150_1' id='label_85_150_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_147\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_147\"><label class='gfield_label gform-field-label'  >Do you plan on screening for food insecurity?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_147'>\n\t\t\t<li class='gchoice gchoice_85_147_0'>\n\t\t\t\t<input name='input_147' type='radio' value='Yes'  id='choice_85_147_0'    \/>\n\t\t\t\t<label for='choice_85_147_0' id='label_85_147_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_147_1'>\n\t\t\t\t<input name='input_147' type='radio' value='No'  id='choice_85_147_1'    \/>\n\t\t\t\t<label for='choice_85_147_1' id='label_85_147_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_148\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_148\"><label class='gfield_label gform-field-label'  >Do you plan on referring individuals who have screened positive for food insecurity to the Greater Cleveland Food Bank Help Center, where they are able to access information about additional food resources, receive aid with SNAP applications, and be referred to additional community resources?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_148'>\n\t\t\t<li class='gchoice gchoice_85_148_0'>\n\t\t\t\t<input name='input_148' type='radio' value='Yes'  id='choice_85_148_0'    \/>\n\t\t\t\t<label for='choice_85_148_0' id='label_85_148_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_148_1'>\n\t\t\t\t<input name='input_148' type='radio' value='No'  id='choice_85_148_1'    \/>\n\t\t\t\t<label for='choice_85_148_1' id='label_85_148_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_149\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_149\"><label class='gfield_label gform-field-label'  >Are you able to provide the Greater Cleveland Food Bank with the number of individuals screened for food insecurity, total number of positive screens, and the number of individuals referred on a semi-annual basis?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_149'>\n\t\t\t<li class='gchoice gchoice_85_149_0'>\n\t\t\t\t<input name='input_149' type='radio' value='Yes'  id='choice_85_149_0'    \/>\n\t\t\t\t<label for='choice_85_149_0' id='label_85_149_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_149_1'>\n\t\t\t\t<input name='input_149' type='radio' value='No'  id='choice_85_149_1'    \/>\n\t\t\t\t<label for='choice_85_149_1' id='label_85_149_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_9\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_9\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Sources of Funding:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_85_9'><li class='gchoice gchoice_85_9_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.1' type='checkbox'  value='Donations'  id='choice_85_9_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_9_1' id='label_85_9_1' class='gform-field-label gform-field-label--type-inline'>Donations<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_9_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.2' type='checkbox'  value='Grants\/Foundations'  id='choice_85_9_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_9_2' id='label_85_9_2' class='gform-field-label gform-field-label--type-inline'>Grants\/Foundations<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_9_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.3' type='checkbox'  value='Fundraising Events'  id='choice_85_9_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_9_3' id='label_85_9_3' class='gform-field-label gform-field-label--type-inline'>Fundraising Events<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_9_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_9.4' type='checkbox'  value='Other'  id='choice_85_9_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_9_4' id='label_85_9_4' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_11\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_11\"><label class='gfield_label gform-field-label' for='input_85_11' >If you selected other, please explain:<\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_85_11' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_10\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_10\"><label class='gfield_label gform-field-label' for='input_85_10' >Explain your programs ongoing funding plan:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_85_10' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_12\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_12\"><label class='gfield_label gform-field-label' for='input_85_12' >What percentage of your food is purchased?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_85_12' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_13\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_13\"><label class='gfield_label gform-field-label' for='input_85_13' >What percentage of your food is donated?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_85_13' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_14\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_14\"><label class='gfield_label gform-field-label' for='input_85_14' >Geographic service boundaries (if any):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_85_14' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_15\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_15\"><label class='gfield_label gform-field-label' for='input_85_15' >Does your program have certain client restrictions?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_85_15' type='text' value='' class='medium'  aria-describedby=\"gfield_description_85_15\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_85_15'>(for example: only church members are allowed to receive assistance) <\/div><\/li><li id=\"field_85_16\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_16\"><label class='gfield_label gform-field-label' for='input_85_16' >How does\/will your organization screen clients for eligibility?  Describe your intake process, on the bottom of the page upload a sample screening\/intake forms if in use:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_85_16' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_139\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_139\"><label class='gfield_label gform-field-label'  >Does your site location have internet and a computer to be used to complete client intake electronically?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_139'>\n\t\t\t<li class='gchoice gchoice_85_139_0'>\n\t\t\t\t<input name='input_139' type='radio' value='Yes'  id='choice_85_139_0'    \/>\n\t\t\t\t<label for='choice_85_139_0' id='label_85_139_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_139_1'>\n\t\t\t\t<input name='input_139' type='radio' value='No'  id='choice_85_139_1'    \/>\n\t\t\t\t<label for='choice_85_139_1' id='label_85_139_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_17\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_17\"><label class='gfield_label gform-field-label' for='input_85_17' >Does your organization require income verification and\/or client identification?  Please explain<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_85_17' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_18\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_18\"><label class='gfield_label gform-field-label'  >Do you\/will you charge a fee or require clients to work\/volunteer in order to receive services?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_18'>\n\t\t\t<li class='gchoice gchoice_85_18_0'>\n\t\t\t\t<input name='input_18' type='radio' value='Yes'  id='choice_85_18_0'    \/>\n\t\t\t\t<label for='choice_85_18_0' id='label_85_18_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_18_1'>\n\t\t\t\t<input name='input_18' type='radio' value='No'  id='choice_85_18_1'    \/>\n\t\t\t\t<label for='choice_85_18_1' id='label_85_18_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_19\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_19\"><label class='gfield_label gform-field-label' for='input_85_19' >If yes, describe fee\/work requirement system:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_85_19' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_20\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_20\"><label class='gfield_label gform-field-label'  >Do you have adequate transportation to pick up product from Food Bank?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_20'>\n\t\t\t<li class='gchoice gchoice_85_20_0'>\n\t\t\t\t<input name='input_20' type='radio' value='Yes'  id='choice_85_20_0'    \/>\n\t\t\t\t<label for='choice_85_20_0' id='label_85_20_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_20_1'>\n\t\t\t\t<input name='input_20' type='radio' value='No'  id='choice_85_20_1'    \/>\n\t\t\t\t<label for='choice_85_20_1' id='label_85_20_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_20_2'>\n\t\t\t\t<input name='input_20' type='radio' value='N\/A'  id='choice_85_20_2'    \/>\n\t\t\t\t<label for='choice_85_20_2' id='label_85_20_2' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_21\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_21\"><label class='gfield_label gform-field-label'  >Do you have adequate volunteers to unload a delivery from the Food Bank?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_21'>\n\t\t\t<li class='gchoice gchoice_85_21_0'>\n\t\t\t\t<input name='input_21' type='radio' value='Yes'  id='choice_85_21_0'    \/>\n\t\t\t\t<label for='choice_85_21_0' id='label_85_21_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_21_1'>\n\t\t\t\t<input name='input_21' type='radio' value='No'  id='choice_85_21_1'    \/>\n\t\t\t\t<label for='choice_85_21_1' id='label_85_21_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_21_2'>\n\t\t\t\t<input name='input_21' type='radio' value='N\/A'  id='choice_85_21_2'    \/>\n\t\t\t\t<label for='choice_85_21_2' id='label_85_21_2' class='gform-field-label gform-field-label--type-inline'>N\/A<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_85_21'>Please note: Delivery fee applies <\/div><\/li><li id=\"field_85_22\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_22\"><label class='gfield_label gform-field-label'  >Do you have regular pest control?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_22'>\n\t\t\t<li class='gchoice gchoice_85_22_0'>\n\t\t\t\t<input name='input_22' type='radio' value='Yes'  id='choice_85_22_0'    \/>\n\t\t\t\t<label for='choice_85_22_0' id='label_85_22_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_22_1'>\n\t\t\t\t<input name='input_22' type='radio' value='No'  id='choice_85_22_1'    \/>\n\t\t\t\t<label for='choice_85_22_1' id='label_85_22_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_23\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_23\"><label class='gfield_label gform-field-label' for='input_85_23' >If Yes, please provide company name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_85_23' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_24\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_24\"><label class='gfield_label gform-field-label' for='input_85_24' >If No, please state the method you use to control pest\/rodent problems:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_85_24' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_128\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_128\"><label class='gfield_label gform-field-label' for='input_85_128' >How many volunteers do you have?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_128' id='input_85_128' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_129\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_129\"><label class='gfield_label gform-field-label' for='input_85_129' >How many paid staff members do you have?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_129' id='input_85_129' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_131\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_131\"><label class='gfield_label gform-field-label'  >Do you have a collaborative partnership with any organizations that provide employment services?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_131'>\n\t\t\t<li class='gchoice gchoice_85_131_0'>\n\t\t\t\t<input name='input_131' type='radio' value='Yes'  id='choice_85_131_0'    \/>\n\t\t\t\t<label for='choice_85_131_0' id='label_85_131_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_131_1'>\n\t\t\t\t<input name='input_131' type='radio' value='No'  id='choice_85_131_1'    \/>\n\t\t\t\t<label for='choice_85_131_1' id='label_85_131_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_132\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_132\"><label class='gfield_label gform-field-label' for='input_85_132' >If yes, what organizations do you work with?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_132' id='input_85_132' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_133\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_133\"><label class='gfield_label gform-field-label'  >Do you have a collaborative partnership with any organizations that provide housing assistance?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_133'>\n\t\t\t<li class='gchoice gchoice_85_133_0'>\n\t\t\t\t<input name='input_133' type='radio' value='Yes'  id='choice_85_133_0'    \/>\n\t\t\t\t<label for='choice_85_133_0' id='label_85_133_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_133_1'>\n\t\t\t\t<input name='input_133' type='radio' value='No'  id='choice_85_133_1'    \/>\n\t\t\t\t<label for='choice_85_133_1' id='label_85_133_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_134\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_134\"><label class='gfield_label gform-field-label' for='input_85_134' >If yes, what organizations do you work with?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_134' id='input_85_134' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_135\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_135\"><label class='gfield_label gform-field-label'  >Do you have a collaborative partnership with any organizations that provide health and wellness services?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_135'>\n\t\t\t<li class='gchoice gchoice_85_135_0'>\n\t\t\t\t<input name='input_135' type='radio' value='Yes'  id='choice_85_135_0'    \/>\n\t\t\t\t<label for='choice_85_135_0' id='label_85_135_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_135_1'>\n\t\t\t\t<input name='input_135' type='radio' value='No'  id='choice_85_135_1'    \/>\n\t\t\t\t<label for='choice_85_135_1' id='label_85_135_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_136\"  class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_136\"><label class='gfield_label gform-field-label' for='input_85_136' >If yes, what organizations do you work with?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_136' id='input_85_136' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_151\"  class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_151\"><label class='gfield_label gform-field-label'  >Are you interested in receiving prepared meals from GCFB&#039;s kitchen (minimum of at least 15 client or resident meals in order to be eligible to receive GCFB prepared meals).<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_151'>\n\t\t\t<li class='gchoice gchoice_85_151_0'>\n\t\t\t\t<input name='input_151' type='radio' value='Yes'  id='choice_85_151_0'    \/>\n\t\t\t\t<label for='choice_85_151_0' id='label_85_151_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_151_1'>\n\t\t\t\t<input name='input_151' type='radio' value='No'  id='choice_85_151_1'    \/>\n\t\t\t\t<label for='choice_85_151_1' id='label_85_151_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_26\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_26\"><h2 class=\"gsection_title\" id=\"pantry-programs\" >Pantry Programs<\/h2><div class='gsection_description' id='gfield_description_85_26'>(Complete this section only if your agency distributes bags\/boxes of food) \nProgram must be open at least 1 time a month all year <\/div><\/li><li id=\"field_85_27\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_27\"><label class='gfield_label gform-field-label' for='input_85_27' >Date current food program began or anticipated start date:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_85_27' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_28\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_28\"><label class='gfield_label gform-field-label' for='input_85_28' >Days\/hours of food program distribution:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_85_28' type='text' value='' class='medium'  aria-describedby=\"gfield_description_85_28\"   aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_85_28'>Please note: Food Bank staff may recommend different days and times for distributions after the Food Bank completes geographic mapping of the area. The Food Bank does not want to duplicate distribution efforts. <\/div><\/li><li id=\"field_85_29\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_29\"><label class='gfield_label gform-field-label' for='input_85_29' >How many households are served (anticipate to be served) monthly:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_85_29' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_30\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_30\"><label class='gfield_label gform-field-label' for='input_85_30' >How many individuals are served (anticipate to be served) monthly:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_85_30' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_31\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_31\"><label class='gfield_label gform-field-label' for='input_85_31' >How many days worth of food do\/will you provide?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_85_31' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_32\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_32\"><label class='gfield_label gform-field-label'  >Is\/will your pantry be open for emergencies?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_32'>\n\t\t\t<li class='gchoice gchoice_85_32_0'>\n\t\t\t\t<input name='input_32' type='radio' value='Yes'  id='choice_85_32_0'    \/>\n\t\t\t\t<label for='choice_85_32_0' id='label_85_32_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_32_1'>\n\t\t\t\t<input name='input_32' type='radio' value='No'  id='choice_85_32_1'    \/>\n\t\t\t\t<label for='choice_85_32_1' id='label_85_32_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_33\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_33\"><label class='gfield_label gform-field-label'  >Does\/will your pantry deliver to guests?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_33'>\n\t\t\t<li class='gchoice gchoice_85_33_0'>\n\t\t\t\t<input name='input_33' type='radio' value='Yes'  id='choice_85_33_0'    \/>\n\t\t\t\t<label for='choice_85_33_0' id='label_85_33_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_33_1'>\n\t\t\t\t<input name='input_33' type='radio' value='No'  id='choice_85_33_1'    \/>\n\t\t\t\t<label for='choice_85_33_1' id='label_85_33_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_34\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_34\"><label class='gfield_label gform-field-label' for='input_85_34' >How often may clients receive food?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_85_34' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_35\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_35\"><label class='gfield_label gform-field-label'  >Is the food storage area secure and locked?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_35'>\n\t\t\t<li class='gchoice gchoice_85_35_0'>\n\t\t\t\t<input name='input_35' type='radio' value='Yes'  id='choice_85_35_0'    \/>\n\t\t\t\t<label for='choice_85_35_0' id='label_85_35_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_35_1'>\n\t\t\t\t<input name='input_35' type='radio' value='No'  id='choice_85_35_1'    \/>\n\t\t\t\t<label for='choice_85_35_1' id='label_85_35_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_36\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_36\"><label class='gfield_label gform-field-label' for='input_85_36' >Describe dry storage area (size, shelves, cabinets, pallets, basement area, etc):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_36' id='input_85_36' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_141\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_141\"><label class='gfield_label gform-field-label'  >Will your organization require delivery of product from the Food Bank&#039;s fleet? (Please note that a delivery fee is associated.)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_141'>\n\t\t\t<li class='gchoice gchoice_85_141_0'>\n\t\t\t\t<input name='input_141' type='radio' value='Yes'  id='choice_85_141_0'    \/>\n\t\t\t\t<label for='choice_85_141_0' id='label_85_141_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_141_1'>\n\t\t\t\t<input name='input_141' type='radio' value='No'  id='choice_85_141_1'    \/>\n\t\t\t\t<label for='choice_85_141_1' id='label_85_141_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_143\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_143\"><label class='gfield_label gform-field-label' for='input_85_143' >If deliveries are needed, please indicate what recurring days and times your agency requests.  All requests are submitted to Fleet for approval.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_143' id='input_85_143' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_53\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_53\"><h2 class=\"gsection_title\" id=\"on-site-meal-providers\" >On-Site Meal Providers<\/h2><div class='gsection_description' id='gfield_description_85_53'>(Complete this section only if clients eat meals or snacks at your location)\nProgram must be open 1 time a month all year<\/div><\/li><li id=\"field_85_54\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_54\"><label class='gfield_label gform-field-label' for='input_85_54' >Date current meal program began or anticipated start date:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_85_54' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_55\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_55\"><label class='gfield_label gform-field-label' for='input_85_55' >What type of program (hot meal, shelter, children\u2019s program etc.):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_85_55' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_56\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_56\"><label class='gfield_label gform-field-label' for='input_85_56' >Days\/hours of feeding program operation:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_56' id='input_85_56' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_57\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_57\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >What kind of meals are served at your site?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_85_57'><li class='gchoice gchoice_85_57_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.1' type='checkbox'  value='Breakfast'  id='choice_85_57_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_57_1' id='label_85_57_1' class='gform-field-label gform-field-label--type-inline'>Breakfast<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_57_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.2' type='checkbox'  value='Lunch'  id='choice_85_57_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_57_2' id='label_85_57_2' class='gform-field-label gform-field-label--type-inline'>Lunch<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_57_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.3' type='checkbox'  value='Snacks'  id='choice_85_57_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_57_3' id='label_85_57_3' class='gform-field-label gform-field-label--type-inline'>Snacks<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_57_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_57.4' type='checkbox'  value='Dinner'  id='choice_85_57_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_57_4' id='label_85_57_4' class='gform-field-label gform-field-label--type-inline'>Dinner<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_58\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_58\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Do you serve your meals<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_85_58'><li class='gchoice gchoice_85_58_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.1' type='checkbox'  value='Daily'  id='choice_85_58_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_58_1' id='label_85_58_1' class='gform-field-label gform-field-label--type-inline'>Daily<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_58_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.2' type='checkbox'  value='Weekly'  id='choice_85_58_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_58_2' id='label_85_58_2' class='gform-field-label gform-field-label--type-inline'>Weekly<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_58_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.3' type='checkbox'  value='Monthly'  id='choice_85_58_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_58_3' id='label_85_58_3' class='gform-field-label gform-field-label--type-inline'>Monthly<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_59\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_59\"><label class='gfield_label gform-field-label' for='input_85_59' >Approximately how many meals are served monthly?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_85_59' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_60\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_60\"><label class='gfield_label gform-field-label'  >Does your agency prepare meals on-site?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_60'>\n\t\t\t<li class='gchoice gchoice_85_60_0'>\n\t\t\t\t<input name='input_60' type='radio' value='Yes'  id='choice_85_60_0'    \/>\n\t\t\t\t<label for='choice_85_60_0' id='label_85_60_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_60_1'>\n\t\t\t\t<input name='input_60' type='radio' value='No'  id='choice_85_60_1'    \/>\n\t\t\t\t<label for='choice_85_60_1' id='label_85_60_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_61\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_61\"><label class='gfield_label gform-field-label'  >Does your agency use catered meals?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_61'>\n\t\t\t<li class='gchoice gchoice_85_61_0'>\n\t\t\t\t<input name='input_61' type='radio' value='Yes'  id='choice_85_61_0'    \/>\n\t\t\t\t<label for='choice_85_61_0' id='label_85_61_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_61_1'>\n\t\t\t\t<input name='input_61' type='radio' value='No'  id='choice_85_61_1'    \/>\n\t\t\t\t<label for='choice_85_61_1' id='label_85_61_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_65\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_65\"><label class='gfield_label gform-field-label'  >Does your agency hold a risk level III or IV with the local health department?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_65'>\n\t\t\t<li class='gchoice gchoice_85_65_0'>\n\t\t\t\t<input name='input_65' type='radio' value='Yes'  id='choice_85_65_0'    \/>\n\t\t\t\t<label for='choice_85_65_0' id='label_85_65_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_65_1'>\n\t\t\t\t<input name='input_65' type='radio' value='No'  id='choice_85_65_1'    \/>\n\t\t\t\t<label for='choice_85_65_1' id='label_85_65_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_95\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_95\"><label class='gfield_label gform-field-label'  >If yes, do you have one (1) person on site that has a State of Ohio approved Food Safety Manager certificate?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_95'>\n\t\t\t<li class='gchoice gchoice_85_95_0'>\n\t\t\t\t<input name='input_95' type='radio' value='Yes'  id='choice_85_95_0'    \/>\n\t\t\t\t<label for='choice_85_95_0' id='label_85_95_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_95_1'>\n\t\t\t\t<input name='input_95' type='radio' value='No'  id='choice_85_95_1'    \/>\n\t\t\t\t<label for='choice_85_95_1' id='label_85_95_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_85_95'>Please know this is a requirement if agency holds a risk level III or IV.<\/div><\/li><li id=\"field_85_62\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_62\"><label class='gfield_label gform-field-label'  >Is your agency licensed and inspected by the Board of Health?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_62'>\n\t\t\t<li class='gchoice gchoice_85_62_0'>\n\t\t\t\t<input name='input_62' type='radio' value='Yes'  id='choice_85_62_0'    \/>\n\t\t\t\t<label for='choice_85_62_0' id='label_85_62_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_62_1'>\n\t\t\t\t<input name='input_62' type='radio' value='No'  id='choice_85_62_1'    \/>\n\t\t\t\t<label for='choice_85_62_1' id='label_85_62_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_63\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_63\"><label class='gfield_label gform-field-label' for='input_85_63' >If yes, what is your license number:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_63' id='input_85_63' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_64\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_64\"><label class='gfield_label gform-field-label'  >Is the food storage area secure and locked?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_64'>\n\t\t\t<li class='gchoice gchoice_85_64_0'>\n\t\t\t\t<input name='input_64' type='radio' value='Yes'  id='choice_85_64_0'    \/>\n\t\t\t\t<label for='choice_85_64_0' id='label_85_64_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_64_1'>\n\t\t\t\t<input name='input_64' type='radio' value='No'  id='choice_85_64_1'    \/>\n\t\t\t\t<label for='choice_85_64_1' id='label_85_64_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_66\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_66\"><label class='gfield_label gform-field-label' for='input_85_66' >Describe dry storage area (size, shelves, cabinets, pallets, basement area, etc):<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_66' id='input_85_66' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_67\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_67\"><label class='gfield_label gform-field-label' for='input_85_67' >Describe kitchen facility:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_67' id='input_85_67' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_144\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_144\"><label class='gfield_label gform-field-label'  >Will your organization require delivery of product from the Food Bank&#039;s fleet? (Please note that a delivery fee is associated.)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_144'>\n\t\t\t<li class='gchoice gchoice_85_144_0'>\n\t\t\t\t<input name='input_144' type='radio' value='Yes'  id='choice_85_144_0'    \/>\n\t\t\t\t<label for='choice_85_144_0' id='label_85_144_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_144_1'>\n\t\t\t\t<input name='input_144' type='radio' value='No'  id='choice_85_144_1'    \/>\n\t\t\t\t<label for='choice_85_144_1' id='label_85_144_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_145\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_145\"><label class='gfield_label gform-field-label' for='input_85_145' >If deliveries are needed, please indicate what recurring days and times your agency requests.  All requests are submitted to Fleet for approval.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_145' id='input_85_145' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_104\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_104\"><h2 class=\"gsection_title\" id=\"please-note-your-program-must-have-at-least-1-refrigerator-and-1-freezer\" >Please note: Your program must have at least 1 refrigerator and 1 freezer<\/h2><\/li><li id=\"field_85_68\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_68\"><label class='gfield_label gform-field-label' for='input_85_68' >Indicate how many residential refrigerators your agency has:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_68' id='input_85_68' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5+' >5+<\/option><\/select><\/div><\/li><li id=\"field_85_69\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_69\"><label class='gfield_label gform-field-label' for='input_85_69' >Indicate how many commercial refrigerators your agency has:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_69' id='input_85_69' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5+' >5+<\/option><\/select><\/div><\/li><li id=\"field_85_70\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_70\"><label class='gfield_label gform-field-label' for='input_85_70' >Indicate how many commercial freezers  your agency has:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_70' id='input_85_70' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5+' >5+<\/option><\/select><\/div><\/li><li id=\"field_85_71\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_71\"><label class='gfield_label gform-field-label' for='input_85_71' >Indicate how many upright freezers your agency has:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_71' id='input_85_71' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5+' >5+<\/option><\/select><\/div><\/li><li id=\"field_85_72\"  class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_72\"><label class='gfield_label gform-field-label' for='input_85_72' >Indicate how many chest freezers your agency has:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_72' id='input_85_72' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='0' >0<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5+' >5+<\/option><\/select><\/div><\/li><li id=\"field_85_73\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_73\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Do you have thermometers in:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_85_73'><li class='gchoice gchoice_85_73_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.1' type='checkbox'  value='Dry storage area'  id='choice_85_73_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_73_1' id='label_85_73_1' class='gform-field-label gform-field-label--type-inline'>Dry storage area<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_73_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.2' type='checkbox'  value='Refrigerators'  id='choice_85_73_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_73_2' id='label_85_73_2' class='gform-field-label gform-field-label--type-inline'>Refrigerators<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_73_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.3' type='checkbox'  value='Freezers'  id='choice_85_73_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_73_3' id='label_85_73_3' class='gform-field-label gform-field-label--type-inline'>Freezers<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_73_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_73.4' type='checkbox'  value='We currently do not have any thermometers in any areas'  id='choice_85_73_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_73_4' id='label_85_73_4' class='gform-field-label gform-field-label--type-inline'>We currently do not have any thermometers in any areas<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_74\"  class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_74\"><label class='gfield_label gform-field-label'  >Do you currently keep temperature logs?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_85_74'>\n\t\t\t<li class='gchoice gchoice_85_74_0'>\n\t\t\t\t<input name='input_74' type='radio' value='Yes'  id='choice_85_74_0'    \/>\n\t\t\t\t<label for='choice_85_74_0' id='label_85_74_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_85_74_1'>\n\t\t\t\t<input name='input_74' type='radio' value='No'  id='choice_85_74_1'    \/>\n\t\t\t\t<label for='choice_85_74_1' id='label_85_74_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_84\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_84\"><h2 class=\"gsection_title\" id=\"conclusion\" >Conclusion<\/h2><\/li><li id=\"field_85_75\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_75\"><label class='gfield_label gform-field-label' for='input_85_75' >Program contact name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_75' id='input_85_75' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_77\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_77\"><label class='gfield_label gform-field-label' for='input_85_77' >Program contact work number:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_77' id='input_85_77' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_76\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_76\"><label class='gfield_label gform-field-label' for='input_85_76' >Program contact cell or home number:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_76' id='input_85_76' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_78\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_78\"><label class='gfield_label gform-field-label' for='input_85_78' >Program contact email address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_85_78' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_79\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_79\"><label class='gfield_label gform-field-label' for='input_85_79' >Director\/Administrator\/Pastor (if different than above):<\/label><div class='ginput_container ginput_container_text'><input name='input_79' id='input_85_79' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_80\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_80\"><label class='gfield_label gform-field-label' for='input_85_80' >Director\/Administrator\/Pastor phone number:<\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_85_80' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_106\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_106\"><h2 class=\"gsection_title\" id=\"authorized-people-to-place-food-orders-at-the-food-bank\" >Authorized people to place food orders at the Food Bank:<\/h2><div class='gsection_description' id='gfield_description_85_106'>All orders must be placed online\n(Up to 3 people) <\/div><\/li><li id=\"field_85_81\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_81\"><label class='gfield_label gform-field-label' for='input_85_81' >Person 1 Name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_81' id='input_85_81' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_107\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_107\"><label class='gfield_label gform-field-label' for='input_85_107' >Person 1 Phone Number:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_107' id='input_85_107' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_105\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_105\"><label class='gfield_label gform-field-label' for='input_85_105' >Person 1 Email:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_105' id='input_85_105' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_108\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_108\"><label class='gfield_label gform-field-label' for='input_85_108' >Person 2 Name:<\/label><div class='ginput_container ginput_container_text'><input name='input_108' id='input_85_108' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_109\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_109\"><label class='gfield_label gform-field-label' for='input_85_109' >Person 2 Phone Number:<\/label><div class='ginput_container ginput_container_text'><input name='input_109' id='input_85_109' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_110\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_110\"><label class='gfield_label gform-field-label' for='input_85_110' >Person 2 Email:<\/label><div class='ginput_container ginput_container_text'><input name='input_110' id='input_85_110' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_111\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_111\"><label class='gfield_label gform-field-label' for='input_85_111' >Person 3 Name:<\/label><div class='ginput_container ginput_container_text'><input name='input_111' id='input_85_111' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_112\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_112\"><label class='gfield_label gform-field-label' for='input_85_112' >Person 3 Phone Number:<\/label><div class='ginput_container ginput_container_text'><input name='input_112' id='input_85_112' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_113\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_113\"><label class='gfield_label gform-field-label' for='input_85_113' >Person 3 Email:<\/label><div class='ginput_container ginput_container_text'><input name='input_113' id='input_85_113' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_114\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_114\"><h2 class=\"gsection_title\" id=\"authorized-people-to-pick-up-food-orders-at-the-food-bank-if-different\" >Authorized people to pick up food orders at the Food Bank (if different):<\/h2><div class='gsection_description' id='gfield_description_85_114'>(Up to 3 people)<\/div><\/li><li id=\"field_85_115\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_115\"><label class='gfield_label gform-field-label' for='input_85_115' >Person 1 Name:<\/label><div class='ginput_container ginput_container_text'><input name='input_115' id='input_85_115' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_116\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_116\"><label class='gfield_label gform-field-label' for='input_85_116' >Person 1 Phone Number:<\/label><div class='ginput_container ginput_container_text'><input name='input_116' id='input_85_116' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_117\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_117\"><label class='gfield_label gform-field-label' for='input_85_117' >Person 1 Email:<\/label><div class='ginput_container ginput_container_text'><input name='input_117' id='input_85_117' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_118\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_118\"><label class='gfield_label gform-field-label' for='input_85_118' >Person 2 Name:<\/label><div class='ginput_container ginput_container_text'><input name='input_118' id='input_85_118' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_119\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_119\"><label class='gfield_label gform-field-label' for='input_85_119' >Person 2 Phone Number:<\/label><div class='ginput_container ginput_container_text'><input name='input_119' id='input_85_119' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_120\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_120\"><label class='gfield_label gform-field-label' for='input_85_120' >Person 2 Email:<\/label><div class='ginput_container ginput_container_text'><input name='input_120' id='input_85_120' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_121\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_121\"><label class='gfield_label gform-field-label' for='input_85_121' >Person 3 Name:<\/label><div class='ginput_container ginput_container_text'><input name='input_121' id='input_85_121' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_122\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_122\"><label class='gfield_label gform-field-label' for='input_85_122' >Person 3 Phone Number:<\/label><div class='ginput_container ginput_container_text'><input name='input_122' id='input_85_122' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_123\"  class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_123\"><label class='gfield_label gform-field-label' for='input_85_123' >Person 3 Email:<\/label><div class='ginput_container ginput_container_text'><input name='input_123' id='input_85_123' type='text' value='' class='medium'      aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_85\"  class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_85\"><label class='gfield_label gform-field-label' for='input_85_85' >Any other pertinent information:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_85' id='input_85_85' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_85_86\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_86\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >To the best of my knowledge the above information is correct:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_85_86'><li class='gchoice gchoice_85_86_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_86.1' type='checkbox'  value='Yes'  id='choice_85_86_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_86_1' id='label_85_86_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_85_86_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_86.2' type='checkbox'  value='No'  id='choice_85_86_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_85_86_2' id='label_85_86_2' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_85_87\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_87\"><label class='gfield_label gform-field-label' for='input_85_87' >Application completed by:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_87' id='input_85_87' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_85_88\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_88\">Completion of this application does not guarantee membership.  We will review your application to ensure it is complete and meets our organizational priorities for membership. Not all applications result in Food Bank membership. <\/li><li id=\"field_85_89\"  class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_89\"><h2 class=\"gsection_title\" id=\"upload-documents\" >Upload Documents<\/h2><\/li><li id=\"field_85_90\"  class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_90\"><label class='gfield_label gform-field-label' for='input_85_90' >501c3 File or Church Qualifier and Supporting Documents<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='51200000' \/><input name='input_90' id='input_85_90' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_90\" onchange='javascript:gformValidateFileSize( this, 51200000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_90'>Max. file size: 49 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_90'><\/div><\/div><\/li><li id=\"field_85_127\"  class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_127\"><a href=\"https:\/\/portal.clevelandfoodbank.org\/agency\/wp-content\/uploads\/sites\/3\/2018\/03\/Church-Qualifier-Form.pdf\" target=\"_blank\">CLICK HERE to download a Church Qualifier Form.<\/a> <\/li><li id=\"field_85_91\"  class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_91\"><label class='gfield_label gform-field-label' for='input_85_91' >Letter of Interest File<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='51200000' \/><input name='input_91' id='input_85_91' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_91 gfield_description_85_91\" onchange='javascript:gformValidateFileSize( this, 51200000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_91'>Max. file size: 49 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_91'><\/div><\/div><div class='gfield_description' id='gfield_description_85_91'>Please note: The letter of interest must be signed by the Director or Pastor<\/div><\/li><li id=\"field_85_92\"  class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_92\"><label class='gfield_label gform-field-label' for='input_85_92' >List of Board of Directors File<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='51200000' \/><input name='input_92' id='input_85_92' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_92 gfield_description_85_92\" onchange='javascript:gformValidateFileSize( this, 51200000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_92'>Max. file size: 49 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_92'><\/div><\/div><div class='gfield_description' id='gfield_description_85_92'>Please be sure this list includes names, addresses and telephone numbers<\/div><\/li><li id=\"field_85_96\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_96\"><label class='gfield_label gform-field-label' for='input_85_96' >Food Safety Certification File<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='51200000' \/><input name='input_96' id='input_85_96' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_96 gfield_description_85_96\" onchange='javascript:gformValidateFileSize( this, 51200000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_96'>Max. file size: 49 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_96'><\/div><\/div><div class='gfield_description' id='gfield_description_85_96'>If you already are certified please upload your certificate. <\/div><\/li><li id=\"field_85_137\"  class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_137\"><label class='gfield_label gform-field-label' for='input_85_137' >Pantry or Hot Meal&#039;s 6 Months of Operation Documents<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='51200000' \/><input name='input_137' id='input_85_137' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_137 gfield_description_85_137\" onchange='javascript:gformValidateFileSize( this, 51200000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_137'>Max. file size: 49 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_137'><\/div><\/div><div class='gfield_description' id='gfield_description_85_137'>Proof of existence may include: 6 months of distribution sign-in sheets, 6 months of food receipts, or 6 months of volunteer work schedules.<\/div><\/li><li id=\"field_85_152\"  class=\"gfield gfield--type-fileupload gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_152\"><label class='gfield_label gform-field-label' for='input_85_152' >Hot Meal Food Safety Certification<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='51200000' \/><input name='input_152' id='input_85_152' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_152 gfield_description_85_152\" onchange='javascript:gformValidateFileSize( this, 51200000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_152'>Max. file size: 49 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_152'><\/div><\/div><div class='gfield_description' id='gfield_description_85_152'>\"ServSafe Manager\" level or equivalent, or certified in \"Food Protection\" with the Ohio Department of Health is required for partners preparing meals.<\/div><\/li><li id=\"field_85_97\"  class=\"gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_85_97\"><label class='gfield_label gform-field-label' for='input_85_97' >Any additional documents you would like to include with your application<\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='51200000' \/><input name='input_97' id='input_85_97' type='file' class='medium' aria-describedby=\"gfield_upload_rules_85_97\" onchange='javascript:gformValidateFileSize( this, 51200000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_85_97'>Max. file size: 49 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_85_97'><\/div><\/div><\/li><li id=\"field_85_153\"  class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below 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*\/\n<\/script>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":19,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"class_list":["post-4574","page","type-page","status-publish","hentry"],"acf":[],"featured_image_src":null,"featured_image_src_square":null,"_links":{"self":[{"href":"https:\/\/portal.clevelandfoodbank.org\/agency\/wp-json\/wp\/v2\/pages\/4574","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/portal.clevelandfoodbank.org\/agency\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/portal.clevelandfoodbank.org\/agency\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/portal.clevelandfoodbank.org\/agency\/wp-json\/wp\/v2\/users\/19"}],"replies":[{"embeddable":true,"href":"https:\/\/portal.clevelandfoodbank.org\/agency\/wp-json\/wp\/v2\/comments?post=4574"}],"version-history":[{"count":0,"href":"https:\/\/portal.clevelandfoodbank.org\/agency\/wp-json\/wp\/v2\/pages\/4574\/revisions"}],"wp:attachment":[{"href":"https:\/\/portal.clevelandfoodbank.org\/agency\/wp-json\/wp\/v2\/media?parent=4574"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}