Grocery Grams Application Form Grocery Gram Application Full Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * (###) ### #### Tell us about you! Help us get to know you and your team putting together the Grocery Gram. * Community Group/Church/Organization if applicable. Please indicate in which way(s) you would like to be a Grocery Grams volunteer: * *note Grocery Grams gift cards and grocery purchases are considered a non-tax-deductable donation Gift Card Grocery Donation Pantry Connections Volunteer Please indicate how often you would like to be contacted for a Grocery Gram request. * The amount you indicate below will be the maximum number of requests CRIS will send you over a period of time. The number of requests you receive might be less than the amount you choose below. Once Once Per Month Twice Per Month Every Other Month Twice a Year If you are applying to be a Pantry Connectors volunteer, would you like to be contacted if a client is in need of immediate (day-of) assistance? Yes, text me Yes, call me Yes, email me No Newly-arrived refugee cases commonly vary from 1-10 indivduals. If you plan to donate groceries or gift cards, please indicate the maximum family size that you feel comfortable shopping for. The dollar values are based on SNAP amounts provided for families. 1 ($48 to $72) 2 ($88.25 to $132.38) 3 ($126.25 to $189.38) 4 ($160.50 to $240.75) 5 ($190.50 to $285.75) 6 ($228.50 to $342.75) 7 ($252.75 to $379.13) 8 ($288.75 to $433.13) 9 ($324.75 to $487.13) 10 ($360.75 to $541.13) I am only applying to be a Pantry Connectors volunteer Preferred Method of Contact Please indicate your most preferred method for CRIS to contact you for a request. Phone Text Email Verification Please enter any two digits with no spaces (Example 12) * Thank you! We will be in touch with you shortly.
