2014 Application for Soup Mix and Fruit Snacks
Ontario Christian Gleaners
1550 Morrison Rd. Cambridge ON N1R 5S2
Important:
Tel: 519-624-8245
Fax: 519-624-4519
E-mail: gleanersmanager@sympatico.ca
Website: OntarioGleaners.org
Complete application form on computer. Remember to save and send as an attachment.
Attach Audited Financial Statements
Email all information to fdc@ontariogleaners.org
Date:
Name of Organization:
Charitable Number:
Address:
City:
Prov. / State:
Post/Zip Code:
Telephone:
Fax
Website:
E-mail:
Contact:
Title:
What is your request? (1 bag of soup mix makes roughly100 cups, when cooked in 25 litres of water.)
Please specify the qty of bags or drums / pails
Bags of Soup Mix:
Bags of Fruit Snacks:
Drums of Soup
Mix: (55 bags)
Drums of Fruit
Mix: (55 bags)
When would you plan to ship?
Do you have the required funds in place to cover shipment?
Where is this food going? (city and country)
In what manner will our donation of
dehydrated Soup Mix affect (hurt/help) the
local economy of the recipients?
Plastic Pails?
(4 bags)
What is your organization doing to reduce and
eventually eliminate the need for food aid?
Is a Phytosanitary certificate required?
Who is handling the
cargo?
How do you intend to
fund the shipment?
Out of existing funds
Through fundraising
How will it be distributed?
Who are the beneficiaries? (Please fill in the approximate number of people)
Poor
Orphans:
Refugees:
Elderly:
Families:
Other or
Comment:
Name the mission organization,
social institutions, hospitals,
churches etc. that will receive the
cargo
Street
Children:
Will you give PROMPT feedback to the Gleaners about suitability of product,
improvements the Gleaners can make, and personal stories about someone who
benefited from this cargo as well as how it will be distributed?
Will you provide digital pictures / video?
Have you received food from
another Gleaners facility?
Which
Gleaners?
What
Year?
The applicant agrees that this product is a donation designated for use on Mission Relief and
Development Projects only. It is not for sale, not for exchange, not for profit or gain, no commercial
value. In signing this application the applicant releases the reports and photos for the Gleaners to be
used as promotional material in their publications and on their web-page.
Applicant Name:
Signature:
Date:
Organizations are requested to make arrangements for pick up within 30 days
Earliest pick up date:
Time:
OCG Rep
Partner Information
It is important for the Ontario Christian Gleaners to know who is implementing the project. This section
gives us some information on your organization and any experience with food and nutrition projects. It also
helps us to understand your basic philosophy and approach to food security and nutrition.
You may use this form to provide the information or you may submit your own.
We would also like to receive a copy of financial statements of previous fiscal year (preferably audited)
Brief history of your
organization: (can paste
info from your website)
Mission statement:
Mandate:
Project Details:
- Name of project
- Objectives
- Background
- Who is implementing
this project
- Duration of project
What role does the OCG
food play in your
program or project?
Your organization's
previous involvement
with food and nutrition
issues:
In addition to the above, you may wish to attach an organizational chart and/or recent annual report.
If you have any questions about this section, please contact the OCG Food Distribution Committee
fdc@ontariogleaners.org or Shelley Stone (519) 624-8245.