Kim's Krew Referrals

Please note that Kim's Krew is operating from a temporary location (not our pantry), so we cannot provide refrigerated food items or bread, and we cannot fulfill personalized orders to the fullest extent. In addition, we are using a private number!

Referral Organization

Referral Staff Name

First NameLast Name

Referral Staff Phone Number

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

Referral Staff Email

example@example.com

If the client needs another referral can they contact you?

Please have them reach out to:

If you are in need of assistance DO NOT fill out the form above. The form is intended for Kim's Krew referral agencies and their staff members. Please call the pantry at 941-792-0993.

Client's Name

First NameLast Name

Client's Phone Number

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

Client's Alt. Phone Number

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

Do you understand Kim's Krew can NOT deliver to any facility with a soup kitchen and/or that serves food?

To qualify for Kim’s Krew services, individuals and their household must meet ALL of the following criteria, please select all that apply to client being referred:

Does the client strongly agree with the statement "I/we do not have food for the next 3 days"?

Comments/Notes (ex. Client needs liquid nutritional supplements, Client is Spanish Speaking only, Client is hard of hearing, etc)

If you are in need of assistance DO NOT fill out the form above. The form is intended for Kim's Krew referral agencies and their staff members. Please call the pantry at 941-792-0993.