Grocery Monthly Reporting – Double Up food Bucks NYS

DOUBLE UP FOOD BUCKS NY GROCERY MONTHLY REPORTING

This report collects monthly metrics from grocery stores and markets operating the Double Up Food Bucks NY GusNIP-funded SNAP incentive programs.

Instructions:

Reports are due on the 10th of each month.
Reports are only accepted using this online form.
Reports are only accepted one month at a time. Please do not use this form to combine multiple months.
If you are unable to track metric, simply input 0.
IMPORTANT NOTE: The form will time-out after a period of inactivity or if you leave the tab/window to work in another tab/window. Please have all information readily available before beginning to input data on the form.

If you have any questions please reach out to Jake Kowal at jkowal@fieldandforknetwork.com or (937) 272-8314

Report Type:

Date Uploaded:
Submitters's First Name:
Submitters's Last Name:
Preferred Method of Contact:

Month:

Year:
Site Name:

Total Operating Days:

(How many total days did you operate Double Up at this location this month?)

Operating Hours:

(On average, how many hours per day is this site open?)

Double Up Distributed (Earned):

(Double Up Distributed to customer for the month. Do not add a $. )

Double Up Redeemed (Spent):

(Double Up Redeemed (Spent) by customers for the month. Do not add a $.)

Double Up Redeem (Spend) Transactions:

(# of Double Up Redeem transactions for the month.)

New Double Up Customers:

(Enter the total number of new Double Up Food Bucks customers this month)

Number of Unique Double Up Customers:

(This is the total number of participants during the previous month that used Double Up at your store.)

Dollar Value of SNAP Sales:

(Total dollar value of SNAP sales for the month. Do not add a $.)

Dollar Value of SNAP Redeemed:

(This is the same number as SNAP Sales. Do not add a $.)

Number of SNAP Transactions:

(Total number of SNAP transactions for the month)

Marketing Needs (optional):

(Do you require any additional marketing materials or would like to speak/meet about marketing Double Up at your store? )

Stories/Highlights (Optional):

(Please provide any stories, highlights, earned-media, or comments that relate to your program. If possible, include a name and contact information for anyone who would be willing to talk about their experience.)

DOUBLE UP FOOD BUCKS NY GROCERY MONTHLY REPORTING

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