Food Security Fund Request

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We are grateful to be able to support Foothills-affiliated individuals and families affected by the pausing of SNAP beneifts. In order for you/your family to receive support from this Fund, you need to have been a regular participant at Foothills for at least three months. The information you share here will help us ensure we can get funds to as many households in our community as may need it.

Email *

Name

Phone Number

# of People and ages in your household

Do you receive SNAP Benefits?

Yes

Other:

Clear selection

Do you receive any other food assistance that is impacted by the government shut down? If yes, please describe here.

Are you furloughed or laid off due to the government shut down?

Yes

Other:

Clear selection

How did you learn about the Foothills Fund?

What form of support would be most useful? (Check all that apply)

Grocery Gift Cards (We are working out the exact amount but it will be at least $150/individual/month)

Emergency Cash Assistance (We are working out the exact amount but it will be at least $150/individual/month)

Prepared Emergency Food Boxes

Someone to talk with / Spiritual Care

Other:

Any thing else you want us to know?

Submit

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