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Our Town Restaurant Application Follow-Up Questionnaire

  1. MEAL DISTRIBUTION PROGRAM (1)
  2. Thank you for your application to participate in the Our Town Meal Distribution Program, a partnership between the City of Jackson and Consumers Energy. Please supply answers to these follow-up questions. All responses must be received by Monday, Jan. 11, 2021 at 12 p.m.
  3. Restaurant Application Information
  4. 1. Are you currently licensed with the Jackson County Health Department?*
  5. 2. Are you currently in violation with the Jackson County Health Department?*
  6. 3. What is the minimum and maximum number of meals you can provide each day if selected to participate in this program?
  7. 4. Meals must be healthy (protein, starch and vegetable), stored and distributed cold with the ability to reheated at home. Please provide a menu of at least three different meal options you plan to serve if selected to participate in this program:
  8. 5. We require local sourcing for this program (within the state of Michigan) at a minimum of 50%. Please submit a list of local vendor’s names and locations you will utilize for this program. Please list vendor name and location city. You may list up to 10 vendors.
  9. I certify that these answers are accurate, to the best of my knowledge.
  10. Leave This Blank:

  11. This field is not part of the form submission.