Community Partner Interest Form

"*" indicates required fields

Are you a tax-exempt organization under section 501(c)(3) or other subsection of the Internal Revenue Code?*

Yes

Unfortunately, we cannot partner with organizations unless they have tax exempt status under Section 501(c)(3) of the Internal Revenue Code. Organizations also cannot be private foundations, even with a 501(c)(3) exemption.

Partner Name*

Partner Representative Full Name*

Contact Phone*

Contact Email*

Partner Address*

Street Address Address Line 2 City State Zip Code

Number of Clients Served*

How many people on average are you serving at each meal?

Primary Clients Served*

Children

Families (adults + children)

Adults (men + women)

Adults (men only)

Adults (women only)

Seniors

Frequency of Meals*

How often and on which days are you serving meals?

Which way would you prefer to be contacted about your application?*

Our organization understands that Second Helpings cannot accommodate dietary restrictions, allergies, or other specific meal requests.

Have you read & understand the statement above?*

Yes

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