COVID-19 Relief (Grab-and-Go) Food Assistance
Agency: Hardee Help Center
713 East Bay Street
Wauchula, FL 33873
Tele: 863-773-0034

Food assistance for Hardee County families impacted by COVID-19 is available. 
This food assistance is offered to households who have experienced job loss or loss of hours due to mitigating efforts associated with the coronavirus outbreak and/or in quarantine.

Documents needed:
Photo Identification
Proof of job loss or loss of hours (i.e., employer's name and phone number)
Proof of local residence

Documents can be emailed to: or presented when picking up your food order. Food orders will be delivered to families in quarantine.

Submit your registration and you will be contacted by phone or email by a Hardee Help Center Team Member.

Please submit only one registration per physical address.

>>>> Applicant must be the person who is registering/completing this form and certify the information provided is accurate.
Email address *
Applicant First, Last Name (Adult Household Member) *
Are you a member of a local church? If so, which church. *
Phone Number (xxx-xxx-xxxx) *
Current Physical Address (Ex. 713 E. Bay Street, Wauchula) *
Adult Household Member DOB *
Adult Household Member Last Four Social Security Numbers (xxxx) *
Gender? *
Adult Household Member Marital Status: *
Disabled? *
Veteran? *
Race? *
Ethnicity? *
Housing? *
Number of Household Members? *
How many children under 17 yrs or younger live in your home? *
Residency? *
Total Monthly Household Income (Ex. $1,200) *
Total Monthly Household Expenses ($1,100) *
Do you receive SNAP assistance (food stamps)? If yes, how much? If no, have you applied? *
Are you aware of other food pantries? *
How has COVID-19 affected your household income? *
Have you or another adult household member experienced one of the following events? *
Provide your employer's business name, supervisor/manager's name and phone number. *
Do you have other needs due to the impact of COVID-19? *
Have you been assisted by the Hardee Help Center in prior years, if so, how? *
Anything else you would like us to know? *
I acknowledge the information I submitted above, or by phone with Hardee Help Center Personnel was truthful and accurate. No fraudulent information was provided in order to obtain services that I would otherwise not likely qualify for. *
I acknowledge the information I have provided is shared with the local churches, as the Hardee Help Center is a ministry of the Hardee County Ministerial Association. That any willful misstatement of information will be grounds for disqualification AND I may no longer receive assistance through the Hardee Help Center in the future. *
By selecting 'Yes' below I hereby authorize the release without liability, information regarding my residency, employment, income, and/or assets to HARDEE HELP CENTER, for the purposes of verifying information provided as part of determining eligibility for assistance under the Hardee Help Center’s Basic Need Program. I understand that only information necessary for determining eligibility can be requested. Types of Information to be verified: I understand that previous or current information regarding me may be required. Verification that may be requested are, but not limited to: employment history, hours worked, salary and payment frequency, commissions, raises, bonuses, and tips; cash held in checking/savings accounts, stocks, bonds, certificated of deposits, Individual Retirement Accounts, interest, dividends; payments from Social Security, annuities, insurance policies, retirement funds, pensions, disability or death benefits, unemployment, disability or worker’s compensation, net income from the operation of a business, property exemption status, and alimony or child support payments. *
Signature is required. By typing your name below, this is your digital signature. You are signing this Form electronically. *
Date Submitted *
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