USDA/TEFAP One-Year Agreement

Error!

One or more of the fields below have not been filled out correctly. Please fill out all required fields and re-submit the form. Thank you.

Error!

Apologies; there has been an error in the form submission process. This issue has been reported to the server administrator. Please allow some time for our team to correct the problem. Thank you.

Error!

There was an issue verifying you. Please try again.

The Emergency Food Assistance Program (TEFAP) Agency Agreement – FY2022

Agency Information

Agency Name * Agency Reference Number * Agency Address * Agency City * Agency State * Agency Zip Code * Agency County * Phone *

Email *

This document serves as an agreement between MANNA FoodBank and the above agency that both parties will comply with the MANNA FoodBank TEFAP Agreement, dated 1 October 2021 to 30 September 2022 (FY2022).

The agency has read the MANNA FoodBank TEFAP Agreement (PDF) in full and understands all sections, as checked below:

Primary Contact

Name * Phone *

Phone Extension Email *

Secondary Contact

Name * Phone *

Phone Extension Email *

Signature

I have read, understand, and attest that my agency will abide by all TEFAP rules and procedures as established by MANNA FoodBank, North Carolina Department of Agriculture, and the United States Department of Agriculture. Failure to do so may result in agency suspension and/or termination from the TEFAP program. This agreement is effective from 1 October 2021 to 30 September 2022 (FY2022).

Name and Title * Agency Signature (please type) * Signature Date * Return Executed Agreement to This Email * Submit Form