CRF Community Table Application - Spring 2022

Contact Information

Name(Required)

First Last

Pronouns (Optional)

Phone Number(Required)

Please provide the best phone number to reach you.

Email(Required)

Organization

Please list your organizational affiliation, if any.

Title

Please list your organizational title, if any.

Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please provide us your mailing address in case we need to send you snail mail.

Interest and Engagement Questions

While these questions are helpful for Good Shepherd Food Bank staff, we value and prioritize your authentic input and feedback. Please feel free to make your answers as long or as short as you would like. A pillar of participatory grantmaking is trusting in our community members and participants.

Have you participated as a CRF reviewer before? (Optional)

Yes

No

Other

Have you applied for and were approved/not approved CRF funding before? (Optional)

Applied and Approved

Applied and Not Approved

Other

Question #1: Tell us of a time when a meal made you feel at home.(Required)

Question #2: Why are the issues of food equity and diversity and food insecurity important to you?(Required)

Question #3: What are you hoping for by engaging in this process?(Required)

W-9 and Payment Options

To help us streamline our stipend process, we would like to encourage participants to provide their W-9 tax documents and payment preferences early. You will have the opportunity to provide this information at the Community Table Orientation and Q&A meeting if you choose not to provide the information through this application.

Participants have the option of receiving a stipend via check or a gift card depending on their individual circumstances. Members also have the option to have the stipend donated to the organization of their choice. Those receiving stipends via check will be required to file a W-9 form.

Payment Options

Stipend Check

Visa Gift Card

Donation to Organization of Choice

W-9 Form (For Stipend Checks Only)

Drop files here or

Max. file size: 100 MB, Max. files: 5.

Link to W-9 Form: https://www.irs.gov/pub/irs-pdf