Food Pantry Distribution Request Form

Food Pantry Distribution Request Form

Please complete the form below to request assistance from the Worship With Wonders Church Food Pantry. Requests will be reviewed and responded to within 48 hours of submission. Assistance is based on current pantry availability, and every request will be considered with care. Once your request is approved, please respond to the pantry email to confirm your scheduled pick-up date and time. If confirmation is not received by the requested deadline, a new request will need to be submitted.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Size of household
Number of family members over 65
Number of children
Ages of children
Zip Code

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you a member of Worship with Wonders Church?
How did you hear about our services?
To help us provide food you can prepare, please select the kitchen equipment you have access to and can use. Check all that apply:

Other
To help us select food that is suitable for your household, please let us know if anyone in your household has food allergies or dietary restrictions.Does anyone in your household have a food allergy?
Pickup is available only during the days and times listed below. Select your preferred pickup date and time below:
After your request is reviewed, you will receive an email requesting your confirmation and pickup details within 48 hours. Your pickup IS NOT CONFIRMED until you respond to that email. Please DO NOT ARRIVE at the pantry unless you have received and confirmed your scheduled pickup time.
Please note: In an effort to adequately support and supply our community with resources, households can request assistance ONCE (1x) every 30 days. Additional requests received before the 30 days will be evaluated based on need pantry supply availabilty.
Please include any additional information our team will need to know.
Should be Empty: