IYG Request for Basic Needs Supplies
Please fill out the form below if you are in need of access to Basic Needs, which includes: Food Pantry, Hygiene Items, Clothing Closet, Laundry Facilities, Shower Facilities, and Transitional Items
These items are available Wednesdays from 4p - 5p on a walk-in basis or by appointment.
Please provide your Preferred Name (First and Last):
If you have one, please provide your IYG Youth ID:
If you need immediate assistance, please continue filling out the information in the form and follow the instructions at the bottom of the page. *If you do not have an IYG Youth ID, please refer back to the "Virtual IYG" webpage and fill out a New Youth Account at the provided link. Once you have created this profile, a case manager will reach out to you to schedule an intake and create a IYG Youth ID.
What Basic Needs Supplies are you needing?
Pre-Packaged Food Items
Pre-Packaged Hygiene Items
Please provide any information that may be helpful for staff to know to better prepare for your appointment (ex. any food or ingredient allergies, type of clothing needed and sizes, etc)
Are you able to visit the Center on Wednesday between 4-5pm? If not, when would you be able to visit the Center to fulfill your request? (Type your availability in the "other" option)
If you are requesting basic needs for a time other than Wednesday between 4-5pm, a case manager will reach out to you to schedule a more convenient time.
Select all acceptable methods of contact:
Provide contact information for all methods of contact listed:
What is your most reliable/preferred method of contact?
This will be how IYG initially attempts to contact you, but any listed method will be used as a back-up.
When would be the next best time to contact you, or please list preferred days and times.
A case manager should reach out to you within one business day to schedule an appointment for pick-up.
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This form was created inside of Indiana Youth Group.