Wiltshire Community Food Providers

We are developing a Wiltshire community food providers interactive map that will show where projects and services are based and will provide further information for residents about eligibility and how to be referred (where applicable). Community food providers are encouraged to add information about their project and service by completing the form below.

The aim of the map is to help:
· direct the public to essential community food support
· better understand the provision across Wiltshire
· build strengths and enable groups to work in a collaborative fashion
· identify and address gaps in provision

Data is collected, held and mapped by Wiltshire Council. If your organisation has multiple food provision locations, can you please submit one form per venue.

Q1	What is the name of your organisation?

Q2	What is the address of your food provision?
	First line:

	Second line;

	Town/Village:

	Postcode:

	Postcode:

Q3	What area(s) does your food provision cover?
	Village / Town / City

	Postcode(s)

Q4	What is the contact telephone number?

Q5	What is the contact email address?

Q6	If you have one, what is your website address?

Q7	Who is the best point of contact for your warm space?
	First name:

	Surname:

Q8	When is your food provision open to the public? Please state day(s), then times e.g. Monday and Tuesday 2pm - 5pm

Q11	If other, please state

Q12

Do you offer food delivery?

Yes, we deliver all food requests

Yes, we can deliver food on request

No, we do not offer delivery

Q13	If other, please state

Q14

Is a referral required to access your food provision?

Yes

Q16	If other, please state

Q17

Please provide details here of any associated costs of attending.

No, we will not ask for any contribution

Yes, we ask attendees to donate what they can afford

Yes, there is a set fee (please enter amount)

Q18	Does your food provider consider and take into account allergies and cultural requirements?

Questions 19 - 25 will not be shared on the interactive map. The following questions will not be shared with the public, this is collected to monitor the scale of food needs in the county, the challenges organisations may face and support they may need.

Q20	If other, please state

Q22

Does your organisation require further funding support to offer its food provision?

Yes - we need further funding to continue our current provision

Yes - with further funding we could expand our provision

Q23

Are you registered with Public Protection as a food business?

Yes

No - if no please register using link below

Exempt (for further information visit www.food.gov.uk/news-alerts/consultation/community-and-food-provision-revised-guidance-on-application-of-eu-food-hygine-law)

Q24	Any other relevant info? (not for the public map)

Q25

Following feedback from various community food providers, we are looking to establish a network of food banks, fridges and other community meal/ food providers. Would you like to participate in a Wiltshire community food network?

Yes, I would like to receive information from the network

Yes, I would like to receive information from the network and I would like to attend informal meetings with colleagues

No, I do not wish to receive information or attend informal meetings

Please ensure you have registered your food activities with Wiltshire Council Public Protection Department. You can register online here: https://www.wiltshire.gov.uk/env-health-food-business

Registration is required in the majority of cases when providing hot or cold food frequently.

Consent

Wiltshire Council would like to publish the information you have supplied about your community food activities on our website www.wiltshire.gov.uk and promote it through our e-newsletters and social media.

Q26

Please confirm that you give consent for the information in questions 1 - 15 to be published, including the contact name, telephone number, email address and website address supplied?

I give consent

Q27

Please confirm that your organisation has an appropriate and current safeguarding policy in place to support your role as a community food provider.

I confirm

If your service offer changes, please re-complete this form and your information will automatically update.

Thank you for completing this form