Mobile Food Pantry Request Survey
Please complete the survey below in order for the ESU Community Navigators can support families with supplemental food boxes. There are no eligibility requirements!!
Would your family benefit from supplemental food through the ESU2 Mobile Food Pantry? *
In order to best serve your family, are there any foods and/or allergies we should try to avoid when packing up supplemental food boxes? *
How many adults (18-64) are in your household? *
How many children (0-17) are in your household? *
How many seniors (65+) are in your household? *
Would there be any adults home during the day to receive a delivery of supplemental foods to your home? *
Address: *
Phone Number: *
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This form was created inside of Educational Service Unit #2. Report Abuse