Lifeboat Food Pantry - New client registration form
Every Thursday from 3 - 5:00 pm

105 Jersey Street, Boston, MA 02215
Contact us at (617) 383-9864, or visit our Facebook page-

Please take a moment to answer all questions so that we may serve you better. For funding and reporting purposes we collect the following information from our clients; however, we will serve anyone in need regardless of ethnicity, race, color, sexual orientation, national origin, gender, age, disability, religious or political beliefs. This information is confidential and will not have a negative effect on services provided to you.
First and Last Name *
Address *
Phone number *
What is your preferred appointment time? (we will try our best to accommodate your request) *
How did you hear about Lifeboat?
Employment status
Clear selection
Estimated total monthly income
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