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GAP Shopping Report

GAP Shopping Report

Please submit within 24 hours of shopping.
Questions? Email morethanameal@mowcm.org

    Fields with an asterisk * are required.


    Note: Please enter N/A if MOW VISA was NOT used.

    Volunteer hours:

    Volunteer miles:

    Please enter each individual payment method amount, including EBT purchases, and attach the receipt image.

    Is this a return? YesNo

    Is this your first time shopping for the client?*

    YesNo

    If yes, please describe the experience:

    Receipt Date: (mm/dd/yyyy)

    Receipt Amount*:

    Payment Method:

    If other, please explain:

    Attach receipt (please use one of the following file types: heic|jpeg|jpg|png|pdf and be sure the file is less than 5MB.

    WERE TWO FORMS OF PAYMENT USED IN THE SAME TRANSACTION OR DO YOU HAVE MORE RECEIPTS TO ENTER?*

    Is this a return?
    YesNo

    Receipt Date: (mm/dd/yyyy)

    Receipt Amount:

    Payment Method:

    If other, please explain:

    Attach receipt

    Is this a return?
    YesNo

    Receipt Date: (mm/dd/yyyy)

    Receipt Amount:

    Payment Method:

    If other, please explain:

    Attach receipt

    Is this a return?
    YesNo

    Receipt Date: (mm/dd/yyyy)

    Receipt Amount:

    Payment Method:

    If other, please explain:

    Attach receipt

    Will the client check be mailed? YesNo

    Did you assist the client with:
    Putting away foodTrashMailOther

    If other, please explain:

    DO YOU HAVE A CLIENT CONCERN REGARDING ANY OF THE FOLLOWING?

    Nutritional Health - Food scarcityEconomic Security - Inability to afford utilities/medications, pet foodHome Safety - Home repairs/maintenance/fall risksSocial Isolation - Lack of support and sense of belonging

    Please explain your concerns:

    Rate your overall experience as a Meals on Wheels GAP volunteer from 1 (Poor) to 5 (Excellent):

    If you wish, please share a story about your volunteer experience:

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