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Food Rescue Organization Donation Receipt Form

Food Rescue Organization Donation Receipt Form

Thank you for joining food recovery efforts in ventura county!

Asterisk (*) indicates the section is required.

Name*
First Last
Email*
Phone*
Food Rescue Organization Name*
Donor Type:*
From what type of food service donor did you receive the donation?
Name of Food Service Donor*
Please enter the name of the food service donor here.
Tax ID #:
Did a food runner or volunteer for transport food?*
- Yes
- No
Did a volunteer help transport the food for you? Please indicate this here.
Volunteer Food Runner Name
If a volunteer food runner transported the food for you, please enter it here.
Please indicate the type of food. i.e. Perishable, nonperishable, fruit, etc.*
- Non-perishable shelf-stable, dry goods
- Breads and pastries
- Produce (Fresh fruits or veggies)
- Perishable prepared cold foods, salads, deli
- Frozen
- Perishable prepared hot foods
- Dairy (eggs, milk, cheese)
- Snacks
Please select the types of food donated.
Nonperishable Pounds
Enter the pounds for this donated category.
Bread or pastries pounds
Enter the pounds for this donated category
Fresh Produce Pounds
Enter the pounds for this donated category
Dairy Pounds
Enter the pounds for this donated category
Dairy Temperature*
Enter the temperature for this donated category recorded at the time of receipt.
Perishable prepared cold pounds
Enter the pounds for this donated category
Perishable prepared cold temperature
Enter the temperature for this donated category recorded at the time of receipt.
Frozen Pounds
Enter the pounds for this donated category
Frozen Temperature
Enter the temperature for this donated category recorded at the time of receipt.
Perishable prepared hot pounds
Enter the pounds for this donated category
Perishable prepared hot temperature
Enter the temperature for this donated category recorded at the time of receipt.
Snacks pounds
Enter the pounds for this donated category
Notes
Upload additional files (allowed are .jpg, .gif, .png, .pdf)
Drop files here or

Accepted file types: jpg, gif, png, pdf.
Please upload photos of the food and/or any invoices or receipts exchanged between you and the food donor.

Contact info

2220 E. Gonzales Rd.
Suite 202
Oxnard, CA 93036
(805) 981-6658
silvia.lopez-navarro@ventura.org
Program Coordinator:
Silvia Lopez-Navarro

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