Emergency Community Pantry by Sikh Food Pantry - Santa Clara County
If you are in need of basic food and groceries due to the recent Coronavirus Emergency please fill out the form below. We will do our best to fulfill your requests but this will be subject to availability. First, we will reach out to you an then we'll plan the delivery or where you can pick up.
____Examples of who SHOULD take advantage of this assistance include those who are:
Elderly who are living alone. Living with existing health conditions, such as diabetes, chronic asthma, etc. Low income/resource
____Examples of who SHOULD NOT take advantage of this assistance include those who are:
Young and in good health. Elderly, who have a family (young and in good health) that resides with them or nearby.High income, healthy individuals/family.
*****Donations are needed. So for those that are NOT low income, we ask your financial support as a courtesy to assist those that can not pay.
******Recipients release all liabilities and take full responsibility for themselves and the items they receive and utilize
* Once the form is submitted: Please expect a call to verify the information and eligibility, and then accordingly a call to schedule the Delivery or Pick Up.
* Groceries: Deliveries typically include about a week's worth of groceries.
_____Sikh Food Pantry is a group of volunteers and Sikh and Community Orgs coming together during the crisis. Ik Onkar Bridges, SiliconValley Gurdwara, JOY of SEWA, Khalis Foundation, Khalsa Aid, and Santa Clara County Supervisor David Cortese's office and community volunteers.
If you have any questions, please email us at
or contact Gurvinder at (408) 390-5025.
Welcome! Please specify if you are a repeat applicant:
If you are a repeat applicant, please share your original Recipient ID #
House # & Street, City, State, Zip
Valid Phone Number
Grocery List (Package typically covers approximately a week of groceries and 2 weeks of staple items such as oil, etc. If you are in need of additional groceries after this request, you may submit another form at the time that groceries are needed).
Canned/Uncooked Beans, Lentils, Daal (2-3lbs)
Grains (Flour/Rice) - (2-3lbs)
Milk (1 gallon)
Bread (1 loaf)
Cereal (1 box)
Peanut Butter and Jelly
Children's Formula or Related
Diapers (please specify diaper sizes in the 'other' section below)
For children: If requested, please specify diaper size and details on formula type
Are you homeless, on welfare, pertain to low-income status or are unable to pay due to special circumstances
Comments (please specify any additional info, or language requirements if other than English)
By filling out this form and/or accepting a grocery delivery, I assume all risks/liabilities associated thereof and keep our volunteers safe and their information private.
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service