BackPack ProgramAgreement 2016-2017

Distribution Location

Name of ALLSchool(s) or Partnering Site(s) under this agreement:

______

______

______

By signing this agreement, both parties acknowledge their respective duties and responsibilities related to the administration of the BackPack Program, which is a program of the Northeast Iowa Food Bank and Feeding America. The BackPack Program meets the needs of food-insecure children by providing them with nutritious and easy-to-prepare food to take home on weekends and school vacations when other resources are not available. Please initial each item after it is read and agreed upon.

Our school/site agrees to the following items.

  1. Identify children to participate in the program based on eligibility guidelines on page 9 of the BackPack Program Information Packet.

  1. Keep registration forms on file for ALL students participating in the BackPack Program.
  2. Distribute backpacks a minimum of once a month during the school year.

  1. Have staff and volunteers with repetitive contact with children pass a national background check.

  1. Food provided for the BackPack Program is to be used in the backpacks ONLY (as outlined in the Food Usage Policy on page 15 of the BackPack Program information packet.

  1. Keep an accurate record of the number of children participating at each location. Inform the Food Bank if and when these numbers change.

  1. Store any food and other BackPack Program supplies in a secure place 6 inches off the floor and 6 inches away from walls.

  1. Ask children to return backpacks to the school following distribution. Inspect backpacks and notify the Food Bank if any replacements are needed.

  1. Use school records to identify food allergies any student may have (peanuts, milk, etc.) and flag their name so that those items will not be distributed to them.

  1. Encourage families, children, and staff to complete evaluations of the program as requested by the FB.

  1. Maintain records of the number of bags handed out, and fax the Monthly Report Sheet by the 5th day of the following month (example: January report by February 5th).

  1. Notify the Food Bank of any changes in the program immediately.

  1. Must attend the annual BackPack Program coordinator meeting and receive food safety training

  1. Monitor site visits conducted periodically by Food Bank staff.

  1. The Northeast Iowa Food Bank is the fiscal agent for the program. Any fundraising and promotion of the program needs to be done in partnership with both entities – this includes any use of our logo, program logos or any information about the Food Bank and its programs.

  1. WATERLOO COMMUNITY SCHOOL SITES ONLY: At the end of each semester, submit a list of all program participants and their ID numbers to the Community Education Office, Attn: Crystal Buzza.

  1. Failure to comply with any part of this agreement will result in a warning. Notification of a warning will be provided in writing. After three warnings are received, the site will closed and must wait six months to reapply to become an BackPack Program site.

We understand that we will receive food and backpacks from the Northeast Iowa Food Bank at no cost to our school/site/agency to help us provide food to children in need. We also understand that the food and backpacks cannot be sold, used for other school programs, fundraisers, given to staff, or used for any other purpose other than to provide food to hungry children.

This Agreement may be terminated at will by either party with written notice delivered to either party not less than 30 days prior to the desired date. Upon termination of this agreement, the Site Coordinator will return any equipment and/or materials provided by the Food Bank for the BackPack Program to the Food Bank within 30 days of the program termination date. This agreement will be effective for one year from the date signed and renewed for each year of participation in the program.

The Northeast Iowa Food Bank strives to include healthy and safe food. While some products might be past the marked “best by” date, we have worked with the manufacturer to ensure it is still safe to consume. If you open the package and notice a problem, please contact the Northeast Iowa Food Bank immediately.

School Principal or Superintendent of SchoolsDate

School Program CoordinatorDate

Address of Distribution Site

City and Zip Code

Community Programs Manager, NEIFBDate

Director of Programs, NEIFBDate

The BackPack Program is a program of the Northeast Iowa Food Bank
1605 Lafayette Street ∙ P.O. Box 2397 ∙ Waterloo, IA50704 ∙ (319) 235-0507 ∙