COVID-19 Relief Meal Delivery Request Form
for Residents of the City of District Heights
In an effort to provide relief to the seniors, veterans and disabled residents in the City of District Heights, The Office of the Mayor has partnered with Carolina Kitchen to sponsor hot meal deliveries once a week on Wednesdays (Noon-2:00pm). Please complete the form below to submit your request.
Questions? Contact Montré Dupree, (301) 531-5182 or email, email@example.com
Person with a Disability
Street Address Line 2
State / Province
Postal / Zip Code
Meals Delivery Schedule
Noon - 1:00 pm
1:00 pm -2:00 pm
# of Meals Requested
(Max 2 per Household)
Special instructions (include any dietary restrictions)
Emergency Contact Phone Number
Please be sure to let us know if there will be a change in your meal delivery time.
Meals will be delivered once a week on Wednesday through December 31, 2020.
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