Organization Name
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Contact Name
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First Name
Last Name
Contact Preferred Pronouns
Organization Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Contact Email
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Phone
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(###)
###
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Annual Budget
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Total Paid Staff/Employees
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How many people are on your Board of Directors?
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Name of Executive Leader and Title
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Describe your current process for recording monetary donations
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Describe your current process for recording in-kind donations
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Describe your organization's fundraising strategy
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How do you fundraise for monetary and in-kind donations?
Mission Statement
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Is your organization currently operating as a hygiene bank or have a hygiene program with a core focus to collect and distribute hygiene resources to those in need?
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Yes
No
How much of your organization's total programs are focused on hygiene and/or basic need distribution?
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100% Hygiene/Basic Needs Distribution
75% Hygiene/Basic Needs Distribution
50% Hygiene/Basic Needs Distribution
25% or less Hygiene/Basic Needs Distribution
Please provide a description of your hygiene bank and/or hygiene service programs, including the services you offer, the communities you serve, and your operational structure.
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Does your organization set & track Impact Goals? If so, please describe them below:
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Describe your organization's process for evaluating impact/Success
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What is your process for distribution of supplies? Include how someone in need would access hygiene supplies from you.
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Select all of the methods of distribution
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How many Hygiene Products do you distribute every year?
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What records does your organization currently keep regarding distribution?
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In what ways are you able to receive feedback/input from clients and the community?
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How do clients learn about your programs?
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Describe your outreach process
Who are your main clients/Recipients?
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Anything else you'd like to share about your main Recipients?
What trainings are provided to your staff and volunteers?
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Describe your organization's understanding of working with an at-risk population
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Do you accept external volunteers?
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Yes, we have a process for new/external volunteerism
All volunteers are connected to our organization/programs directly
We do not have a volunteer platform
Describe how your organization is engaged with others in the community, such as other service providers, people with lived experiences, and community groups.
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Please provide your organization's anti-discrimination policy/statement.
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Put "No formal statement" if you do not have one current
Does your organization have Value Statements? If so, please include them here:
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Which of the following are you most interested in utilizing?
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Select all that apply
Select all that are true
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Please confirm that all of the above is true and accurate to the best of your knowledge.
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