Thames Foodbank - parcel application

Important please read before continuing:

Our foodbank is experiencing high demand. Therefore the limit is 2 food parcels per household per year unless your support Agency is applying on your behalf (e.g. Thames Budgeting Service) or you have exceptional circumstances.

- Only whanau or individuals living in the Thames area are eligible for a food parcel through Thames Foodbank.

- You must provide proof of ID and proof of your household current address (even if you have had a food parcel in the past) - (e.g. login to your myMSD on your phone).

- We may ask you for proof of why you need a food parcel or if you have been declined by WINZ for a food grant.

- Register using our online form (below) or text, phone. or drop into 305 Mary Street for further instructions. See a separate form for pet food application.

- If applying on behalf of a relative or friend, we will contact that person to confirm their request or we will decline the application.

- Pick up only from 305 Mary Street, Thames: we do not do deliveries.

REMINDER - YOU MUST Bring ID and a current proof of address.

There will be a time delay in receiving your parcel as we will review and approve your application.

Please contact us on phone (07) 868 6274 or mobile / text (021) 215 1154 if you would like to discuss, or email us on: foodbankthames@lwt.org.nz.

Our opening hours are Monday to Thursday only from 10am - 11:30am.

Today's Date*

Date

Name*

First NameLast Name

Home Address or where your mail is sent - You MUST provide proof on pick up and it must be within the last 6 months*

Phone Number*

Area CodePhone Number

Email - please make sure its a valid email as this will be your main form of contact. If no email - leave blank.

example@example.com

Ethnicity - let us know your main ethnicity*

MaoriNZ EuropeanOther

If Ethnicity is "Other" - please specify*

Date of birth*

Date

Gender*

MaleFemaleOther

Identification - you MUST provide ID and proof of address on pick up (e.g. myMSD on your phone)*

Identification - if "Other" - what is your ID?*

Reason For the use of foodbank*

Please select from the drop down.

If "Other" - please comment on your reason for the use of the service*

When was your last pay? (if Agency application use today's date)*

Date

When is your next pay? (if Agency application use today's date)*

Date

Have you applied for a WINZ food grant?*

YesNo

If "No" - please comment on your reason for not applying for WINZ*

Have you had a parcel from a Foodbank since January 2025?*

Yes - Foodbank ThamesYes - Other FoodbankNo

Where was the other Foodbank you used?*

If you have used a Foodbank before, you may be asked to provide proof of need and a budget plan. Remember - the limit is 2 parcels per household a year unless an Agency is applying on your behalf (e.g. Thames Budgeting Service) or you have exceptional circumstances.

How many people is this food parcel for?*

How many are adults 18+?*

How many are children under 18?*

Please let us know any other additional support you may need (if any). If you are an agency filling this form out for a client please add you comment here.

Additional Items

If you require other items such as tooth paste, nappies, or sanitary items please ask on arrival. We can provide only if available.

Pet food

We have a separate online form for cat and dog pet food for you to complete. We can only provide pet food only if available.

I declare that the information I have given is true, and give my permission for Living Well Trust to hold this information and check with referring agencies if necessary.

Applicant Signature*

Review process - click "Review" forSubmit button at bottom

Review

How many food parcels been given since Jan25?

How many emergency bags been given since Jan25?

How many food parcels given during the 2024 year?

CONSULT REQUIRED WITH TEAM LEADER BEFORE PARCEL APPROVED?*

YesNo

Did they answer "No" to if had a food parcel question - but have had a food parcel?

Yes - need to remind client they have had a food parcel and how many they are entitled to.No

Type of Food Parcel to be given

ID and Address Checked?

YesNo

Identification - type checked

ID number - or details if "Other" selected

If ID not checked - comment why

Name of Referral Agency (or write "None"

Form filled in correctly and completely?

YesNo

Form not complete - comment why and what is missing

Additional items given

Any other notes to write (if any)

Approver 1 - name

Approver 2 - name

Parcel Approved or Declined?ENSURE THIS IS CORRECT AND COMPLETE - as client will receive an auto-email with the result

ApprovedDeclinedOther (only use when editing form)

Food parcel declined - comment why

FORM PRINTED AND FILED

YesNo

Foodbank Thames - food parcel application

Two approvers to complete to sign off