Restaurant Voucher Registration Form Logo
  • Dine Out Club Registration Form

    Meals on Wheels of Hillsborough County (HCMOW), a non-profit organization, depends on participant donations, state/federal funding, and grants to provide services like Community Dining and the Dine Out Club. By sharing your demographic information, including estimated income, you are helping HCMOW compete for crucial grants and funding to continue these vital community programs! All information shared will be kept confidential. PLEASE NOTE: Dine Out Club card processing may take up to 8 weeks due to the program's tremendous popularity.
  • The Dine Out Club is currently available to individuals 60 and older who are NOT receiving home delivered meals.

  •  - -
  •  

    Your Dine Out Club card will processed and mailed to you within 8 weeks.

    By clicking submit, I acknowledge that I have read the guidelines and have provided true and accurate information.

  • Nutritional Risk Screening

    The following are true/false questions to complete the Nutritional Risk Assessment. Please circle true or false based on how the statement applies to you. Your score will be calculated by a Meals on Wheels representative.
  • Should be Empty: