Request for Partnership Application (rev 10.8.24)

Section 1: Application Overview

Thank you for your interest in partnering with Connecticut Foodshare. Due to a high volume of requests and limited capacity, Connecticut Foodshare is not able to approve every request for partnership. We prioritize new partnerships that are open to the public, reaching an underserved community, and in a location where other food assistance options are limited. Whenever possible, we encourage collaboration with established programs to enhance services already available.

Before you start this application, please take a few minutes to review the following:

Throughout this application, you will be asked to describe your organization and your food assistance program. Many of the questions assume that your food assistance program is already up and running. If it is not, please answer questions as if it were, according to the plans you have made. In this application, you will be asked to submit the following documents:

Federal IRS 501c3 Determination Letter (required if you are applying as a 501c3 Public Charity)
Annual Operating Budget (revenue and expenses) for your Food Assistance Program (required)

If you have questions about this application form, please contact Codi Wayton at cwayton@ctfoodshare.org or 203-741-9215. Once submitted, the person completing this form will receive an email with a copy of the submitted application. Decisions will be communicated via email following a formal review process.

Section 2: Organization Information

Organization’s Name. If you are applying as a 501c3 Public Charity, the Organization Name should match your IRS Determination Letter that you will attach at the end of this section.*

Organization’s Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Organization’s Phone Number*

Describe the mission or goals of your organization in a few sentences.*

Organization’s Website (if available)

Which best describes your organization?*

A 501(c)(3) Public Charity, as defined by the Federal IRS, that serves people in needA Church/Religious Organization without 501(c)(3) status that serves people in needMunicipality without 501(c)(3) status that serves people in need

What is your organization's federal EIN? If you are applying as a 501c3 Public Charity, the EIN should match your IRS Determination Letter that you will attach next. Before submitting your application, be sure to check the IRS website here to confirm that your 501c3 Public Charity status is current.

Organization's Federal EIN*

Required Document – Upload the Federal IRS 501c3 Determination Letter for the Organization and EIN listed above.*

Browse Files

Section 3: Contact Information

Person Completing This Form

Name*

First NameLast Name

Title*

Email Address*

example@example.com

Phone Number*

Are you the Main Contact for the food assistance program? The main contact is the lead person responsible for managing the relationship with Connecticut Foodshare and is typically the person who runs the day-to-day of the program.*

YesNo

Are you the Executive Contact for your organization, such as Faith-Leader or Executive Director?*

YesNo

Main Contact for the Food Assistance Program. If approved for partnership, this will be the lead person that Connecticut Foodshare will communicate with about the day-to-day operations of your program

Name*

First NameLast Name

Title*

Email Address*

example@example.com

Phone Number*

Is the Main Contact also the Executive Contact at your organization? If approved for partnership, the Executive Contact will be the person responsible for signing the Agency Partner Agreement with Connecticut Foodshare on behalf of the Organization listed earlier in this application, such as the Executive Director or Faith-Leader.*

YesNo

Executive Contact for Parent Organization. If approved for partnership, this will be the person responsible for signing the Agency Partner Agreement with Connecticut Foodshare on behalf of the Organization listed earlier in this application, such as the Executive Director or Faith-Leader.

Name*

First NameLast Name

Title*

Email Address*

example@example.com

Phone Number*

Optional: Secondary Contact for the Food Assistance Program. If approved for partnership, this will be the person Connecticut Foodshare will list in our records as a back-up to your Main Contact involved in the day-to-day operations of the program.

Name

First NameLast Name

Title

Email Address

example@example.com

Phone Number

Optional: Finance Contact for the Food Assistance Program. If approved for partnership, this will be the person responsible for receiving invoices and monthly statements from Connecticut Foodshare, in addition to the Main Contact.

Name

First NameLast Name

Title

Email Address

example@example.com

Phone Number

Section 4: Program Information

In the following sections, please provide information about the food assistance program you are seeking partnership for.

Program Name*

Program Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Program Type (select one)*

Food PantryCommunity KitchenEmergency Shelter

When did, or will, your program launch?*

Which best describes your program?*

We currently operate a food assistance program and are looking for more foodWe do not yet operate a food assistance program and are looking to get started

Describe your food assistance program in a few sentences.*

How will partnership with Connecticut Foodshare improve your ability to serve your community?*

Section 5: Community Access

Who is eligible to receive food assistance through this program? If your program is only open to a specific population or region, please include that information here.*

What days/times does your program distribute/serve food? Connecticut Foodshare requires partners to operate at least twice a month, every month, on a set schedule.*

What is the average number of people served (or anticipate serving) each time you distribute/serve food?*

Describe the steps your program takes to ensure that the people you serve feel welcome. Connecticut Foodshare expects partners to maintain a program that is welcoming to people from all backgrounds, experiences, and abilities with services that are reliable and easily accessible to the community. *

Describe your intake process. What information or documents do you ask individuals to provide? Generally, Connecticut Foodshare recommends a limited intake process to reduce barriers.*

How do people select their groceries or meals? Generally, Connecticut Foodshare recommends as much choice as possible. For instance, at pantries, we recommend that people are able to shop for the items they prefer, like a grocery store.*

How do you (or will you) promote your program to the community?*

Does your program provide the people you serve with information and resources that go beyond food, or help connect people to other community resources? If yes, please describe.*

Does your program offer services in any languages other than English? If yes, please describe.*

Name two similar food assistance programs closest to you. If you are a pantry, please list pantries closest to you. If you are a meal program, please list meal programs. You can find programs near you at 211ct.org

What steps have you taken to coordinate efforts with the two programs listed above?*

How is your food assistance program filling a need not currently met by these nearby programs? Consider what sets your program apart, such as your location, the population you serve, how services are provided, or your hours of operation.*

Is your program affiliated with a faith-based organization?*

YesNo

Are religious services held directly before or after food assistance is provided?*

YesNo

Is attendance in religious services required in order to receive food assistance?*

YesNo

Does your food assistance program primarily serve members of your congregation?*

YesNo

Section 6: Program Capacity

Is your program run by paid staff or volunteers? Please describe.*

What is the total annual budget for this program? You will be asked to upload a copy of the program’s annual operating budget (revenue and expenses) at the end of this section.*

What are the primary sources of funding for your program? Connecticut Foodshare expects that partners have some capacity to raise financial donations to support your program operations.*

What are your other sources of food? Connecticut Foodshare expects that partners have other food sources beyond our food bank.*

Describe the space dedicated to your program, including where food is stored.*

Do you have refrigerators for this program? If so, how many?*

Do you have freezers for this program? If so, how many?*

Do you have the capacity to pick-up orders at one of Connecticut Foodshare’s distribution centers? Locations include Wallingford, Bloomfield and Bridgeport.*

YesNo

Connecticut Foodshare has some limited capacity to offer delivery to new partners where there is room in our truck schedule. If approved for partnership, you will be asked to fill out a separate Delivery Request Form that our Transportation Department will review to see if we have availability in our truck schedule. Will you need delivery in order to partner with us?*

YesNo

Required Document: Upload the Annual Operating Budget (revenue and expenses) for your Food Assistance Program*

Browse Files

Section 7: Closing Questions & Comments

Please share any additional questions or comments for Connecticut Foodshare to help us review your request for partnership.