Outreach Request Please complete this form to request a truck or counselor at an event. Truck: The GCFB Outreach Truck can bring small amounts of fresh produce and shelf stable food* to an outside event as well as engage individuals around SNAP, other Public Benefits and community resources. *based on product availability Outreach Counselor: GCFB Outreach Counselors are available to engage individuals at various community organizations, health partners and emergency feeding programs around SNAP, other Public Benefits and community resources. Type of Request* Truck Outreach Counselor Name* First Last Organization/Group Name* Email* Phone*Preferred Method of Contact* Email Phone HiddenDate MM slash DD slash YYYY HiddenStart Time* Start Date* MM slash DD slash YYYY Start Time* : Hours Minutes AM PM AM/PM End Date* MM slash DD slash YYYY End Time* : Hours Minutes AM PM AM/PM Location* Street Address Address Line 2 City ZIP / Postal Code Expected Attendance*Approximations are fine!Demographics*Ex: Seniors, Adults, Children, etc. Description of Event* Food Resources (if available)*Food resources are subject to availability Produce Shelf Stable Items Snack Items None Is this event free to the public?* Yes No How did you hear about us?* What is the mission of your event?HiddenHow did you hear about us? OLD First Choice Second Choice Other HiddenEnter Other OLD CommentsThis field is for validation purposes and should be left unchanged.