Allen JH/HS Survey
Food Pantry Application and Toiletries Survey
JH/HS Food Pantry
Allen JH/HS is teamed up with the Regional Food Bank of Oklahoma with the help of the Chickasaw Nation to provide a food pantry for students in grades 6-12. The purpose of the Food Pantry is to provide students with extra food for the weekend who might not otherwise have food when they cannot eat at school. We served up to 60 students when we were first hit with the pandemic in March and continued through May. We have been able to replenish our pantry and are ready to help out anyone in need. We will be handing out backpacks with food every week beginning on Tuesday, October 13th before Fall Break begins. After Fall Break, we will be handing out the backpacks on Fridays. We also have toiletries such as deodorant, shampoo and conditioner, soap, toothbrushes, toothpaste, personal products and a few other items that people in our community have donated to help our students out. Please answer the following questionnaire if you think that your student(s) may qualify for this program. Again, we want to help and this is confidential. (If you know of a student in need, you may recommend them using this same survey.) The questionnaire is sent only to Mrs. Costner. You must meet the criteria of the Regional Food Bank of Oklahoma to receive food. The toiletries are not part of the Food Bank. Once your application is received, you will be contacted.
Please check as many boxes that apply to your student(s)
Loss of income
Doesn't have enough food at home to eat during the weekend
Inability to concentrate
Always asking for more food than you can provide
I do not need food this service
If you need any of the following toiletries, please check the boxes that apply.
Toothbrush and Toothpaste
Please list the name and grade of each student in grades 6-12. If they have siblings enrolled in our lower elementary, please list those students too.
Please list contact information--name and phone number
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This form was created inside of Allen Public Schools.