Request edit access
St. Stephen's Thrift Shop Voucher Request
Thank you for your reaching out to us. Our Shopping Voucher program is available to help people in need of assistance with clothing, household goods, and items for enjoyment such as books, music, games and toys. 

We welcome referrals from local churches, nonprofit organizations, and direct appeals from individuals seeking assistance. Direct requests from individuals without a referral may be required to show current need such as a receipt of Public Assistance (PA), SNAP, or NYS Unemployment Benefits.

A Voucher covers:
  • Clothing items up to $ 200 value per household member, (limit of 4 people per household)

  • Household items up to $100 value per household (dishes, linens, decor, etc)

  • Christmas Holiday decorations: up to $50 per household

  • Other: Media (books, CDs, DVD), games, toys  and jewelry, up to $25 value per household member


Sign in to Google to save your progress. Learn more
Email *
Requesting a Voucher For: *
First and Last Name
Recipient's Home Address *
Number of Children Living in Household  *
Number of Adults Living in Household  *
Organization Making This Referral *
Contact From Referring Organization (Name, role, phone, email) *
Email to send Voucher on approval
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of St. Stephens Episcopal Church.

Does this form look suspicious? Report