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Recipient Agency Application

Thank you for your interest in becoming a Table to Table recipient partner.  We look forward to working with you soon! 

Step 1: Please complete the Table to Table application

Step 2: Upload copies of both your 501c3 and current satisfactory health inspection.

If you prefer, you can email the copies of your 501c3 and current satisfactory health inspection to: jkinner@tabletotable.org or mail them to:

Table to Table 160 Pehle Avenue, Suite 303 | Saddle Brook, NJ 07663  Attention: Julie Kinner

If you have any questions, please reach out to Julie Kinner at 201-681-0862.

Agency Application Form

Agency Application Form

Not for Profit:(Required)
501 (c) (3) Tax Status:(Required)
Volunteers / Staff Available to Help with Delivery:(Required)
Admin Contact:(Required)
Type of Program(Required)
Major Demographic:(Required)

Staff Contact #1:

(available during deliveries)
Name:

Staff Contact #2:

(available during deliveries)
Name:

Staff Contact #3:

(available during deliveries)
Name:

What days and time can you receive food?

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Available freezer space:

(write down the number)

Available Refrigerator space:

(write down the number)
Do you or does someone on your staff have Food Safety Certification?(Required)
Is your kitchen under the jurisdiction of the local health department?(Required)
Do you have a current Board of Health Certificate?(Required)
Are you willing to take a food safety handling class?(Required)
Do you agree to reasonable inspection of your facility for evaluation?(Required)
Will you agree to follow specified food handling guidelines?(Required)
Drop files here or
Max. file size: 50 MB.
    Signature Required
    MM slash DD slash YYYY