Food Basket Program Registration Form
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Total Number in the Household
Total Number in the Household Under the Age of 19
School District(s) Where Children Attend
Fenton School District
Linden School District
Lake Fenton School District
Are any Children on Free or Reduced Lunch Program?
Yes
No
How Did You Find Out About This Program?
Pick-up is at the Fenton United Methodist Church Family Life Center, 119 S Leroy St, Fenton, from 11 a.m. to 2 p.m. on Tuesday, November 24th.
If you are unable to pick up at this time, please check here.
Submit
Should be Empty: