Feed Seniors Now Participation Form
Let us know about your local Feed Seniors Now® food drive campaign so we can tell others about your success!
Franchise Owner's Name
*
First Name
Last Name
Franchise Office Number
*
Campaign Contact Name
*
First Name
Last Name
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Best way to contact me is:
Phone
Email
Start Date of Your Feed Seniors Now® Campaign
-
Month
-
Day
Year
Date
End Date of Campaign
-
Month
-
Day
Year
Date
How Will You Be Participating?
Hosting a Food Drive (please complete information below)
Hosting a Lunch & Learn Program
Hosting a Group Meal
Participating in a Health Fair
Hosting a Health Fair
To promote your event, do you plan to... (check all that apply)
Promote via press releases to media
Paid advertising-radio, TV, print, direct mail
Use social media -list below
Partner with a local media outlet
Partner with local businesses
Partner with referral sources
Social Media -please list (FB, Twitter, etc)
Paid advertising mediums used
Feed Seniors Now Food Drive Information
Kick-Off Date
-
Month
-
Day
Year
Date
End Date
-
Month
-
Day
Year
Date
Local Goal - Pounds of Food
Local Goal - Dollars Raised
Submit
Should be Empty: