SNAP Outreach: Partner Interest Form

The New Hampshire Food Bank has been awarded the state contract for implementing the NH SNAP Outreach Plan. The Supplemental Nutrition Assistance Program, also known as SNAP, provides nutrition benefits to eligible low-income individuals and families so they can purchase healthy food and move towards self-sufficiency. 

As the NH Food Bank continues to offer SNAP Outreach and Application Assistance, they are looking to identify partners that can support the work within their own communities. If you are a community-based human or social service agency or provider* in NH that would benefit from learning about this critical food access resource, SNAP, please sign up using this form. 

Please fill out the form in its entirety to best identify the efficacy of a potential partnership.

*Agencies and providers that fall into the following categories are highly encouraged to fill out the form; NHFB partner agencies, health care providers, community health centers or health care clinics, Community Action Program (CAP) agencies, Meals on Wheels programs, Family Resource Centers, Housing authorities, homeless service providers, veteran service providers, food pantries, soup kitchens, senior centers.

This interest form is to identify marketing partners who are interested in distributing SNAP Outreach materials provided by NHFB (print and digital) to increase SNAP awareness and SNAP enrollment in NH. 


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Organization Name *
Complete Mailing Address *
Contact Name & Job Title *
Phone Number *
E-mail Address *
Type of agency/organization? Please list as many as are relevant. *
Required
What is your organization’s work and mission? 
Please include the types of services, programs, trainings, etc. you offer to your clients.
How will you distribute SNAP outreach materials to your clients (mail, take home bags, front desk, during screening, etc.)? *
What areas of the state does your agency serve? 
Please name specific cities, counties and/or regions.
What are the general demographics of your client base?  Please list as many as are relevant. *
Required
In general, how many clients does your organization directly serve per week, month, or year?
How many SNAP brochures would you use?
You may choose from any of the following: Generic,  Generic Spanish, Older Adults, Families with Young Children.
 *
How many SNAP posters would you use?
Size: 18" x 24"
 *
How many SNAP jar openers would you use?
Will you be providing some/all of these materials to other organizations for disbursement?
 *
I would like a NHFB SNAP representative to attend a tabling/canvassing event at my location or to provide on-site application assistance. (Briefly describe event with date/days/time, if available).
Thank you for your interest in supporting the New Hampshire SNAP Outreach program!  We will contact you to discuss the partnership and look forward to working with you soon!                                                    
For further questions or information please call the NHFB SNAP Outreach Coordinator at 603-669-9725 ext 1147, snap@nhfoodbank.org.
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