Benton Methodist Food Pantry Application
Please fill out as much information as you can below to make your application process faster. We are a food pantry for Bossier Parish residents in Benton, LA. You need your Louisiana ID or DL, utility bill for proof of residence, and proof of income or SNAP budget sheet. If you need to find the pantry nearest you, please contact the NWLA Food Bank at 318-675-2400. If you need further information, please contact Rachel at 318-935-8515 before 2 PM Tuesday-Thursday. Distribution is on the 3rd Wednesday of each month from 1230-4 PM except in December when it will be the 2nd Wednesday.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred Phone
*
Please enter a valid phone number.
Email
*
example@example.com
Personal Information
Please enter your information
Date of Birth
*
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Month
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Day
Year
Date
Driver's License/ID State
Please Select
Lousiana
Other
Driver's License / ID Card Number
Must be a valid Louisiana license or ID Card
How do I qualify?
If you receive SNAP (food stamps) or SSI you automatically qualify, otherwise we go by monthly income. Please select the appropriate box below:
How do you qualify? (if you do not have SNAP, SSI or no income, select income and we will determine your eligibility based on income)
*
SNAP (Food Stamps)
SSI
Homeless/Not Working
Income
Other
If you selected income, please enter the total household monthly income.
Enter income
Family Information
Please enter information for each family member below
Name
Date of Birth
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Month
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Day
Year
Date
Family Member Relationship
Husband
Wife
Son (& by marriage)
Daughter (& by marriage)
Other
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Date of Birth
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Date
Family Member Relationship
Husband
Wife
Son (& by marriage)
Daughter (& by marriage)
Other
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Date of Birth
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Family Member Relationship
Husband
Wife
Son (& by marriage)
Daughter (& by marriage)
Other
Name
Date of Birth
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Family Member Relationship
Husband
Wife
Son (& by marriage)
Daughter (& by marriage)
Other
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Date of Birth
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Husband
Wife
Son (& by marriage)
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Date of Birth
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Husband
Wife
Son (& by marriage)
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Date of Birth
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Husband
Wife
Son (& by marriage)
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Date of Birth
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Husband
Wife
Son (& by marriage)
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Submit
Should be Empty: