Food Assistance Information

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HOPE Church Food Pantry is open on the 2nd, 4th and 5th Wednesday of each month, 1:00-2:15pm. Enter via the church parking lot at 700 Cooper Road, Voorhees, NJ. DELIVERY IS UNAVAILABLE. Patrons will NOT be permitted to enter the parking lot prior to 12:15pm. Please complete this form prior to coming.

When you visit our pantry for the first time, a laminated ID Card should be waiting for you when you get to the front of the line. If it is not yet ready, it will be waiting for you the next time you come, but you will be able to receive food regardless of whether or not the card is ready on your first visit.

First Name / Nombre *

Last Name / Apellido *

Date of Birth (MM-DD-YYYY) / Fecha de Nacimiento: (mes / día / año) *

How many adults (age 18 or older) live in your household? / ¿Cuántos adultos (más de 18 años) viven en su hogar? *

How many children under age 18 live in your household? / ¿Cuántos niños (menos de 18 años) viven en su hogar? *

Qualifying Reason *

Low Income

Existing Local, State or Federal Program Participant (Example - WIC)

Disaster (Other - Can be divorce, domestic violence, unusal expense, loss of employment, etc.)

Required

If "Disaster" is selected, please explain

I Am Accepting A Charitable Donation Of Food From The Emergency Food Pantry. I Hereby Relilnquish The Food Pantry Of All Liability Of Any Nature Whatsoever And Accept The Food Products "As Is" And At My Own Risk.
*

Yes

Required

I Certify That My Total Yearly Gross Household Income Is At Or Below 185% Of The Poverty Level, OR That My Household Participates In The Program(S) I Have Checked On The Emergency Food Registration Form
*

Yes

Required

I Will Also Notify The Pantry, If There Are Changes To My Income Or Qualifiers Which May Cause Me To Become Ineligible For The TEFAP Foods.
*

Yes

Required

Street Address / ¿Cuál es la dirección? *

City / Ciudad *

State / Estado *

Zip Code / Código Postal *

Phone Number / Numero de Telefono *

Email Address / Correo Electrónico *

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