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 Student Food Pantry Intake Form
If you are interested in obtaining food from the Schoolcraft Student Food Pantry, please fill out the following form. A representative of the Student Activities Office will contact you regarding your application. Distribution of food will be done on the 4th Friday each month during the fall semester while supplies last. If you have any questions, please contact the Student Activities Office at 734-462-4422 or email: sc.sao@apps.schoolcraft.edu.
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Email *
Student Number:
Name:
Address:
Phone:
Age:
Gender:
Credits Presently Enrolled In:
Student Status:
Current Source of Income:
Please list the total number of people at this address that will be utilizing the pantry:
How many are adults:
How many are Schoolcraft Students:
Number of children 0-5 years old:
Number of children 6-18 years old:
Total number of people served:
How did you hear about the Schoolcraft Student Food Pantry? If you were referred to the pantry please list the name of the friend, instructor or department that made the referral:
PLEASE READ THE FOLLOWING STATEMENT BEFORE Agreeing: I understand that food distributed at the Schoolcraft Student Food Pantry has been donated from various on-campus and off-campus partners, and that none of the parties or groups involved in the program make any warranties as to the quality of the food or its value for any particular purposes. I voluntarily accept the food “as is.” By checking I agree below, I release the Schoolcraft Student FoodPantry, Schoolcraft College, and the original donor from any liability for harm (including injury or death) or losses in connection with the food or supplies I have received. I assume any risks and covenant not to sue the released parties with respect to such harm or losses. I understand that the Schoolcraft Student Food Pantry operates on limited funds and in support of others, and not as a service of Schoolcraft College. I will not abuse the services of the Schoolcraft Student Food Pantry. I will only request and take items that I reasonably expect myself and/or my family to use.
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