OFL Agency Application

This application is required for all agencies and organizations that are interested in hosting a class series at their site. Please complete this form, and return via email, mail or fax to:

Operation Frontline, Attn. Erika Pijai

Capital Area Food Bank, 645 Taylor Street, NE, Washington, D.C. 20017

Phone: 202-526-5344 x227 Fax: 202-529-1767, “Attention to Erika”

Agency / Organization Contact Information

Agency/Organization Name: Date:

Agency Street Address: ______

Agency Street Address: ______

City: State: Zip:

Primary Contact Person: Job Title:

Phone Number: Fax Number: Email:

Organizational Information

1.  How do you classify your agency / organization? (i.e. School, Church, Community Center, Wellness Center, Housing Development, Food Pantry, etc.)

2.  Briefly describe your organization’s work and mission. (Include the types of services, programs and training you offer to your clients)


3.  Is your organization a current Partner Agency of the Capital Area Food Bank? Yes No

4.  Does your agency serve low-income individuals? Yes No

How do you determine low-income eligibility? Can you provide us with this verification?


5.  What type of clients do you serve?

Ethnic Background:

Age Range of Clients: Sex:

Economic Situation:

Do they receive WIC, Food Stamps or other nutrition assistance? Yes No
If yes, what % of those served participate in nutrition assistance programs? %
Other Details:

6.  How would you rate participation levels among eligible clients for community service programs offered by your organization?

High (100% - 80%) Moderate (79% - 50%) Low (49% - 20%)

7.  Facility at your organization:

a.  Does your organization own or have access to a working kitchen facility for cooking classes? Yes No
(If not, does the facility offer access to a non-bathroom sink with hot water, for hand/dish washing?
Yes No

b.  and have access to a classroom area large enough to accommodate 10–16 people?
Yes No

c.  and will your agency provide access to a working refrigerator in order to store groceries for class (if requesting a cooking & nutrition class series)?

d.  and is your facility easily accessible for clients who rely on public transportation?
Yes No

e.  and does your agency currently have a van (or other means of transportation) and valid insurance for transporting clients and participants to and from your site and/or other locales?
Yes No

f.  and do you have the ability to provide childcare during adult classes if necessary?

Yes No Not Applicable

8.  Recruiting Participants. Operation Frontline can provide agencies with flyer designs to assist with recruitment; however, it is the agency’s responsibility to recruit the class participants. What is your current method of recruiting participants for various programs?

Flyers Phone Calls Mailings Newsletter Other:

Operation Frontline Assessment

9.  How did you hear about the Operation Frontline program?


10.  Have you observed or previously hosted an Operation Frontline class? Yes No
If so, please provide the following information:

Course Name:

Class Location (e.g. agency/organization name):

11.  Why are you interested in bringing Operation Frontline courses to your clients and/or community? In what ways do you think that cooking and nutrition education would benefit your participants?

12.  Which Operation Frontline courses are you interested in hosting?

Eating Right (adults)

Kids Up Front (ages 8-12)

Power of Eating Right (teens ages 13-18)

Side By Side (kids & parents/caretakers) Step Up to Eating Right (pregnant/parenting teens)

Saving Smart, Spending Smart (financial planning course)

Eating Well (for those living with HIV/AIDS and their caretakers)

13.  Please list any languages (other than English) commonly used by your clients.

14.  Requesting Classes: What months, days, and times are convenient for hosting an Operation Frontline class series at your facility? Please give your top three choices; if very flexible, please note! (We will get back to you if your request matches with the availability of the program instructors.)

Class Series Request: [Please give 1st, 2nd, & 3rd choices (Monday – Friday preferred) for day of the week]

DAY OF THE WEEK STARTING DATE TIME OF DAY (CHECK ONE)

1. / AM / PM / Evening / Flexible
2. / AM / PM / Evening / Flexible
3. / AM / PM / Evening / Flexible

15.  Please list any other existing relationships/arrangements that could help support your class implementation (e.g., relationships that could result in in-kind donations of food or other class materials, volunteers, etc).

16.  Your commitment to hosting an Operation Frontline class series is important to the overall success of this program at your agency. Are you willing and able to be actively involved in recruiting participants, be accessible via email and phone for class planning purposes, provide a realistic participant count each week, be present during classes and assist with class preparation and other class needs?

Yes No

Date:

CONTACT PERSON SIGNATURE

Thank you for your interest in the Capital Area Food Bank’s Operation Frontline program! After reviewing your application, we will contact you to discuss the possibility of hosting a class series at your agency. We hope to work with you soon!

For further questions or information please call Erika Pijai at

202-526-5344 Ext. 227 or e-mail at

Be sure to check out our website for more information: www.capitalareafoodbank.org/OFL

*For Operation Frontline office use only*
Date Application Received:
Date reviewed:

Reviewed by:

Recommendation/Next Steps:
Class Code:
Date Class Held:

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