Registration

Registration

Thank you for your willingness to register online as we do our part to help meet the needs of our community while also fighting the spread of illness.
In order to register as a new client and/or volunteer at the Little Chapel Food Pantry, we need just a little bit of information that will allow us to stay in communication with you, and also to let us know your family size so that we can determine how much food you are eligible for.

Your email address is important! There may be times we need to reach you, such as a food recall notice or a distribution cancellation in case of bad weather. The best way for us to do this is by email. With the many clients we have, we do not have the time to call every client without email. Free email addresses are available through hotmail.com, gmail.com and yahoo.com which can be accessed from the library.
Name*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Best Phone Number to Reach You*

Area CodePhone Number
Email*
example@example.com
I am a:*

ClientVolunteerBoth

Signature and Submit
All information is treated with the utmost care and privacy. By signing below you attest that all information is correct and that you will provide us with updated information if it changes.
Is the current health crisis the primary reason you came to Little Chapel Food Pantry?*

YesNo
If you received a registration card from us at our drive-through distribution, please enter the number here:
Signature*

Clear