Uptown Solidarity Network COVID-19 Support Form
This is an emergency food assistance request form.
For deliveries, we distribute food on Thursday evenings and Sunday early afternoons.
For distribution to houseless folks, we do food distribution with the Urban Bicycle Food Ministry on Monday and Thursday nights.
If you would like food or other supplies dropped off at your front door and you live in the Uptown or Buena Park Neighborhoods, please use this form.
If you live outside of Uptown, there are many neighborhood groups doing the same all across the city -
Lincoln Square/Ravenswood Solidarity Network, Edgewater Solidarity Network, Little Village Solidarity Network, Pilsen En Defensa, Rogers Park Solidarity Network, and Rogers Park Food Not Bombs.
We are prioritizing folks who are sick or have compromised immune systems, disabled, quarantined without income, houseless, economically disadvantaged, elderly, undocumented, queer, and/or people of color, or who have families in need.
We are a small. all-volunteer grassroots neighborhood collective operating in the Uptown/Buena Park neighborhoods with limited funds.
We are not a food pantry, large non-profit, charity organization, government agency, or private corporation.
Since we have limited funds and people, our first priority is making sure that those who are in isolation (sick, elderly, or those who have compromised immune systems) &/or unable to pay, receive food.
Do know that sanitation equipment like lysol wipes & gloves are hard to come by in stores at this time, and thus we are not able to distribute these items at this time.
Name (This does not need to be your legal name. Add your pronouns, too, if you want!)
Which one best describes your situation?
I cannot leave the house because I am sick, elderly, disabled, or immunocompromised. I am able to pay for groceries.
I cannot leave the house because I am sick, elderly, disabled or immunocompromised. I can pay for some of my groceries.
I cannot leave the house because I am sick, elderly, disabled, or immunocompromised. I am not able to pay for groceries at all.
I am an individual and am able to go to the grocery store, but I do not have funds to buy any food because I am recently unemployed and/or houseless
I am an individual and able to go to the grocery store, but I am low income and need some financial assistance to purchase groceries.
I have a family and am able to go to the grocery store, but I do not have funds to buy food because I am recently unemployed and/or houseless
I have a family and am able to go to the grocery store, but I am low income.
How should we contact you?
If you selected phone, what is your phone number?
If you selected email, what is your email address?
How many people are in your household?
Dietary Restrictions, Allergies, or Intolerances
Halal, kosher, vegetarian, vegan, allergic to peanuts, lactose intolerant, gluten-free, scent sensitive, etc -- this is important in case we're trying to substitute "our best guess for what you'd like" in place of "something you asked for" that's out of stock.
What types of food do you want?
Ingredients to cook with.
Reheat and serve/frozen.
Low prep (like mac & cheese, sandwiches, etc)
Do you need someone to pick up your prescriptions for you? If yes, which pharmacy?
If yes, please provide us a phone number to reach you. We will need your legal name, date of birth, and the names of the medications. We will not collect this information on a Google Form (they are not secure enough!)
Do you have any other needs or requests?
Delivery Address (if you are houseless, please provide street intersection where we can meet you on Thursdays at 8p.m or so)
Any additional specifications, comments, questions, accessibility needs, or drop off instructions?
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