5th MLK Registration Form

Registration Form
We’ll be distributing hot meals, pantry items, and winter essentials to those in need; rain or shine.

*One bag of food per car, first come, first served, while supplies last. No exceptions, please.

🌟 Event Details:

📅 When: Saturday, January 17, 2026

⏰ Time: Starting at 12 PM

📍 Location: Church on Main
2400 Main Street E.
Snellville, GA 30039
Recipient Information

Please complete the fields below
Your Name*

PrefixFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Contact Number
Please enter a valid phone number.
Are you a military veteran?*

NoYes
How did you hear about us?

WebsiteFriendSocial mediaOther
For fairness to all attendees, each vehicle will receive only one bag of provisions. Supplies are limited and available on a first come, first served basis. We cannot offer guarantees or exceptions. Thank you for your cooperation and understanding.*

Yes, I understand
Thank you!
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Registration Form