Food locker request
Please answer the following questions to submit your request for a food locker. 

Please note that the Locker Program will be a lottery when we have more requests than lockers. Also note that if chosen for this cycle, you need to pick up your order within 48 hours after the locker is filled. If selected, you will recieve 6 weeks of locker access, after which you will need to reapply. 

*If you miss your window, this may prevent future requests from being accepted. 
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First and Last name *
Physical Address *
Email Address *
Phone number we can text you an access code. If no phone, please share your email address so a code can be sent. *
To help us understand your needs, please share any challenges that make it difficult for you to visit local food banks or our Thursday Market (for example: work schedule, transportation, health concerns, or other barriers). Please be as specific as possible. *
Number of adults are in your household *
Number of children are in your household (if any), and their ages *
Food allergies we should be aware of *
Where did you hear about your program? *
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