2026 Maywood Mission Food Box Application
The Maywood Easter giveaway will take place on Friday, March 27th, 2026 between 10am and 2pm. This program is ONLY for an Easter meal. If you have any questions, call 740-901-3027 Option 1 (Thrift Store).
Qualification Questions
Is your place of residence within Fairfield County? This program is for residents of Fairfield County only.
*
Yes
No
Back
Next
Sorry, you are not eligible for this program.
If you have any questions, or if you do not have an ID or permanent address due to homelessness or some other extenuating circumstance, please give us a call at 740-901-3027 Option 1 (Thrift Store). Thank you!
Back
Next
Personal Information
Name
*
First Name
Last Name
Phone Number - we will be texting your pickup reminder to this number!
*
IMPORTANT: Please enter a valid phone number. We will send a text reminder to this number.
Email - If you do not input an email you will not receive confirmation of your submission.
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
*
-
Month
-
Day
Year
Date
Are you a caseworker completing this form for a client?
*
Yes
No
Caseworker Name
*
First Name
Last Name
Caseworker Agency
*
Caseworker Contact Number
*
-
Area Code
Phone Number
Back
Next
Easter Food Box Questions
How many people live in your household?
*
Back
Next
Last Step - Submit!
Sign and click the button below to submit your application.
By signing below and submitting this application, you attest that the information contained in this form is correct and valid to the best of your knowledge.
*
Submit
Should be Empty: