Michigan Health & Hospital Association
 2011 Michigan Harvest Gathering
MHA Post-Food-Drive Reporting Form


Once your Michigan Harvest Gathering food drive is successfully completed, you need to report the results to the Michigan Health & Hospital Association. This report is used by both the MHA and the FBCM to verify your organization's donation for the overall totals collected by MHA members. Harvest Gathering Campaign's financial donations should be designated to regional food banks in your area. The campaign cannot allocate funds to individual food pantries. Questions on the requested information may be directed to Paige Hathaway at the MHA.

Date:
Organization: *Required
Project Leader - Name:
Phone:
E-mail: *Required
Name and address of food bank or organization where the donations were sent:

Total Donation:

Actual Pounds of Food:

Actual Dollars:

**Please DO NOT convert dollar amounts to pounds!**

Describe a particularly successful method used to promote the drive, or other interesting details: