NYA Free Food Distribution Delivery Form
Free food distributions are held in Norwood Young America once a month, typically on the second Wednesday of the month. We are piloting a delivery program for older adults (65+) in NYA, Hamburg, and New Germany who are homebound, have mobility issues that prevent them from participating, or do not have transportation. 

Please fill out this form or call Shelly at 952-243-0883 to sign up. Registrations must be received at least 7 days prior to the event date to receive a mobile delivery. Filling out the form does not ensure a delivery - you will receive a phone call to confirm. You may only sign up for the upcoming distribution (i.e., you cannot sign up for more than one month at a time).

Find a list of upcoming distribution dates here: https://www.facebook.com/scdcap/

All participants must live in the 55339, 55367, 55368 or 55397 zip codes; be 65 years or older; and be homebound, have mobility issues that prevent them from participating and/or do not have transportation. 

Deliveries will be made between 11:30am - 3:00pm on the date of distribution. Participants must be present to receive the delivery. Volunteers will drop food off at your doorstep but are not able to unpack groceries.

Please contact Shelly at 952-243-0883 if you have any questions or would like to sign up over the phone.
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First and Last Name
Phone Number
What is your zip code? Note that only people living in the 55339, 55368 and 55397 zip codes are eligible to participate.
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Are you currently experiencing mobility issues that prevent you from participating in the monthly distributions, lack transportation, or are homebound? Select all that apply. 
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