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Navigation Menu
Home
Our Work
Our Partners
Take Action
News
Contact Us
National Office
Western Cape
Eastern Cape
Gauteng
KwaZulu-Natal
North West
Free State
Limpopo
Northern Cape
Mphumalanga
Apply
Official COVID-19 Website
store activation form
Store Activation Form
Store Name:
*
Retailer / Outlet:
*
Store Manager:
*
Landline No:
*
Store Manager’s Cell:
*
Email:
*
Store’s FoodShare Contact:
*
Designation:
*
FoodShare Contact’s Cell:
*
Email:
*
Store Code:
Street Address
*
Suburb
Province
Postal Code
GPS Longitude:
*
GPS Latitude:
*
Has store received the FoodShare Guidelines?
*
YES
NO
Does store agree to comply?
*
YES
NO
COLLECTION DETAILS
Please indicate which BO is collecting on what day and time of collection.
Monday
Collection Time
Hours
Minutes
BO Collecting
Tuesday
Collection Time
Hours
Minutes
BO Collecting
Wednesday
Collection Time
Hours
Minutes
BO Collecting
Thursday
Collection Time
Hours
Minutes
BO Collecting
Friday
Collection Time
Hours
Minutes
BO Collecting
Saturday
Collection Time
Hours
Minutes
BO Collecting
Sunday
Collection Time
Hours
Minutes
BO Collecting
Initial to Sign acceptance
*
Date
*
Submit Form
