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Food Pantry Grant Program 2024 Application

Food Pantry Information

United Dairy Industry of Michigan, Blue Cross Blue Shield of Michigan, Blue Cross Complete of Michigan and the Blue Cross Blue Shield of Michigan Foundation are proud to partner with food pantries to provide dairy foods, equipment and resources supporting an increase in distribution of dairy foods and other fresh food options to clients. Our goal is that all clients visiting Michigan’s food pantries have access to nutrient-rich dairy foods and, when possible, fresh vegetables and fruit.

1. Food Pantry Name: *This question is required.

2. Food Pantry Street Address: *This question is required.

3. City: *This question is required.

4. Zip *This question is required. This question requires a valid number format.

5. County *This question is required.

6. Food Pantry Phone Number: *This question is required. This question requires a valid number format.

7. Applicant First Name: *This question is required.

8. Applicant Last Name: *This question is required.

9. Applicant Title: *This question is required.

10. Applicant Email Address: *This question is required. This question requires a valid email address.

11. Applicant Phone Number:
Please list the phone number that we can best reach you at for grant application questions. *This question is required. This question requires a valid number format.

12. Phone Number Type: *This question is required.

13. The applicant listed above is the primary contact person at the food bank to coordinate grant acceptance, requirements, equipment delivery and funding acceptance. *This question is required.

If the applicant is not the primary contact, please list the primary contact below:

First Name *This question is required.

Last Name: *This question is required.

Title: *This question is required.

Email Address: *This question is required. This question requires a valid email address.

Phone Number: *This question is required. This question requires a valid number format.

Phone Number Type: *This question is required.

14. Where you referred to this application by a Michigan Dairy Producer? *This question is required.

Please enter an 'other' value for this selection.