501 (c) (3) tax-exempt status

Other Sources of Food Donations (*)

As a Waste NOT Recipient Partner Agency, we understand that:


1. Waste NOT does NOT charge fees for food deliveries.


2. In order to support our deliveries, Waste NOT depends upon foundation and corporate funders who often require data on those we serve to substantiate the need for funding.


Therefore, as a recipient partner, we agree to provide Waste NOT with demographic information – to the best of our knowledge – as well as provide annual survey feedback as requested.


Please complete the following section based upon the unduplicated count of individuals served for a 12 month period in your last fiscal year:

Note: Please use annual numbers (not percentages) in all categories


Number of Gender/Age Served in Each Category Annually:




Number of all Race/Ethnicity in Each category Annually:

(Total of all categories below should match annual figure)

We also certify that we will not sell, offer for sale, transfer or barter any of the food provided by Waste NOT; that we have adequate refrigeration and food preparation/storage capabilities, and that we will not deny food provided by Waste NOT on the basis of race, creed, national origin, religious affiliations, gender, sexual preference, age or handicap.

For Waste NOT office use only

Major Crossroads: