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More Than a Mealâ„¢

GAP Shopping Report

Please submit within 24 hours of shopping trip using the latest versions of Chrome, Safari, Firefox, or Edge. Questions? Email morethanameal@mowcm.org

Fields with an asterisk * are required.



Please enter the individual receipt total and attach the receipt image.
Is this a return? YesNo

Receipt Date: (XX/XX/XXXX)

Receipt Amount:
Payment Method: If other, please explain:

Attach receipt (please use one of the following file types: jpeg|jpg|png 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: (XX/XX/XXXX)

Receipt Amount:
Payment Method: If other, please explain:

Attach receipt

Is this a return? YesNo

Receipt Date: (XX/XX/XXXX)

Receipt Amount:
Payment Method: If other, please explain:

Attach receipt

Is this a return? YesNo

Receipt Date: (XX/XX/XXXX)

Receipt Amount:
Payment Method: If other, please explain:

Attach receipt

Will the client check and/or receipt be mailed? YesNo

Did you assist with putting food away? YesNo

Did you help the client in another capacity? YesNo
If yes, please explain:

DO YOU HAVE A CLIENT CONCERN? YesNo
If yes, please explain:

Have you seen that your grocery client has made wiser food choices since they started the program? YesNo
If no, please explain:

Have you noticed that your grocery client is selecting more fruits and vegetables, or other healthy options? YesNo
If no, please explain:

My client always wants me to shop for:

My GAP client appears to have enough food in the home: YesNo
If no, please explain:

My GAP client's home appears neat and in good repair: YesNo
If no, please explain:

My GAP client appears socially engaged and in good spirits: YesNo
If no, please explain:

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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