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JFS Food Pantry Delivery and Prepared Meal Delivery Request
This survey will inform us if you would like to start to get delivery and is required for the service. After enrollment you will need to call 734-769-0209 ext. 6 or email
foodpantry@jfsannarbor.org
to RSVP for additional deliveries. People under the age of 60, without pre-existing medical conditions, will need to attend curbside service on Thursdays.
* Required
What is your full name (First and Last)?
*
Your answer
Are you an existing JFS client?
*
Yes
No
What is your street address?
*
Your answer
What is your Zip Code?
*
Your answer
What is your phone number?
*
Your answer
What is your email address?
Your answer
Are 60 years old or older?
*
Yes
No
What race to you identify as?
*
This is used to inform funders of the demographics of the clients served.
Choose
American Indian/Alaskian Native
Asian
Black/African American
Multi-racial
Native Hawaiian or other Pacific Islander
White
Other
Undeclared/Unknown
Declined
What is your annual income?
*
This in no way affects whether or not someone is eligible for services and is captured only for demographic purposes for funders.
Choose
>10k
10k-25k
26k-50k
51k-75k
76k-100k
>100k
Declined
Unknown/Undeclared
Next
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