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Brown Bag Program - Reporting Instructions and Forms
The Brown Bag Program is a State-funded program that provides surplus and donated edible fruits, vegetables, and other food products to low income individuals 60 years of age and older. The food is distributed to help supplement the nutritional needs of these older individuals. There is no fee charged to participants, although voluntary contributions can be made.
The food is distributed at various locations throughout the State. The types and amounts of food distributed vary depending on the season and other factors. Volunteers, the majority of whom are older individuals, help provide the time and energy to sort and distribute these food items, thereby gaining an increased sense of purpose and the satisfaction of helping others.
Current Form
- Brown Bag Program Monthly Activity Summary Form (CDA 5) (rev. 07/2000)
Brown Bag Model Intake Form and Quarterly Report Form to be used July 1, 2008!
The following form is a model to use as data collection and is not sent to the Department. This form is meant as a convenience to you and may be revised for the specifics of your program.
- Brown Bag Intake Instructions (rev. 01/2008)
- MODEL Brown Bag Intake Form (CDA 1029) (rev. 01/2008)
- MODEL Brown Bag Intake Form (CDA 1029) (rev. 01/2008)
The following form is the official form for submission to CDA. This form may not be modified. Any variations of the official form will be returned.
- Brown Bag Program Quarterly Activity Report Instructions (rev. 01/2008)
- Brown Bag Program Quarterly Activity Report Form (CDA 5) (rev. 01/2008)
- Brown Bag Program Quarterly Activity Report Form (CDA 5) (rev. 01/2008)
NOTE: All documents are available in various formats, i.e. pdf, rtf, xls or doc. You can download any of the readers from our Download Tools area. If you have questions about the Reporting Forms or Instructions, please call (916) 928-5859.