Provide Meals | Feed Spokane

Agency Name*

Contact Name*

Contact Phone*

Contact Email

Location Information

Physical Address*

Street Address City State ZIP Code

We are interested in providing the following meals:

We are interested in providing meals on these days:

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We are aware of the value of attending coalition meetings and will appoint a representative to attend these coalition meetings.

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We understand and agree to assign someone with a valid food handler’s permit to pick up food for use at our meal site. (Please advise if assistance is needed in obtaining a food handler’s permit)

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We understand and agree to contact the Spokane Regional Health District for approval 324-1560 ext: 2

Phone

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