2026 Food Distribution Request Form

🌟FOOD BOX DISTRIBUTION🌟

Food Distribution for Families Impacted by Foster Care

🗓️ When: Thursday, June 25th, 2026

⏰ Time: 12 PM – 2 PM

📍 Location: ASA Now - Jacob's Mission Community Center

🏠 Address: 7830 E. University Dr. Mesa, AZ 85207

(University and Sossaman - entrance is immediately east of the fire station)

✨ Who can Participate: DCS Kinship Caregivers, Licensed Foster Caregivers, Foster/Adoptive Caregivers, Guardianship Caregivers for children who previously were or are under the custody of Arizona Department of Child Safety (DCS) and aged out youth up to age 21 with proof of previous or current child welfare involvement.

For questions, call or text 480-415-4481

🤝 Driving and Pick-Up Instructions: We are located on University between Sossaman Rd. and 80th St. on the north side of the street. Parking lot entrance is immediately east of the fire station and our building is set back off of the road. Please drive up to the front sidewalk of the building and pull forward and our volunteers will load your food box into your vehicle for you.

Come prepared with a cooler or cooler bag to put frozen or refrigerated food into. We will not know exactly what we are getting until we pick items up, but we typically receive shelf stable foods, bread, produce, refrigerated, and frozen items.

⚠️ Cancellations: We understand that emergencies happen. If you are unable to pick up your food, please send someone in your place and let us know who will be coming.

by calling 480-415-4481.

✨ Feedback: Our donors and volunteers love feedback. If ASA Now has blessed your life, please take a minute to leave a positive review on ASA Now Google Review

For a list of our upcoming events, check out our Events tab on Facebook or visit our website at www.asanow.org.

With Gratitude,

💙ASA Now

Caregiver, Parent or Aged Out Youth Name

First NameLast Name

Name of Group Home (type N/A if you are not a group home)

Cell Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

E-mail

Address

Street Address

CityPostal/Zip Code

COUNTY

Date of Food pick up

Are you:

Total Number of Adults Living in the Home (including children over 18 who are no longer in high school)

Total Number of Children Living in the Home (including children over 18 who are still in high school)

Number of Children in Foster Care, Tribal Foster Care, or DCS Guardianship Living in the Home (including those 18 and over who are still in high school):

Number of Adopted Children Living in the Home (including children 18 and over who are still in high school):

Number of Biological Children Living in the Home (including children 18 and over who are still in high school):

Number of NON-DCS Kinship or NON-DCS Guardianship Children Living in the Home (including children 18 and over who are still in high school):

We are required to gather data about the children, youth, and families we serve. This question will ask if your family falls below following income levels based on household size: 1 person: $23,940 / 2 people: $32,460 / 3 people: $40,980 / 4 people: $49,500 / 5 people: $58,020 / 6 people: $66,540 / 7 people: $75,060 / 8 people: $83,580 / Add $8,520 per additional household member

Based on family size, does your family fall below the income level shown above? (Group homes, please click yes)

As a foster care nonprofit organization, we must obtain certain information from the families we serve. If you are caring for a child or youth with child welfare involvement, we must collect their Notice to Provider information.

If you have been served by ASA Now and you have uploaded their Notice to Provider information for any of our events in the current year, you may skip the questions below.

If you have never upoloaded their Notice to Provider, this information and/or if they are a new placement in your household, please fill out the form for EACH Eligible DCS Guardianship, Child in Foster Care or Aged Out Youth in order of youngest to oldest.

Have you provided information in the current year for each child in your home who is: in foster care, tribal foster care, DCS guardianship, or Aged Out Youth?