Thames Foodbank - day bag application

Important please read before continuing:

Our foodbank is experiencing high demand. An emergency food bag may be available once a week if your household has reached your annual limit of 2 food parcels.

The food bag is available once every 7 days for up to 12 food bags a year limit after your household is not entitled to a food parcel.

The food bag includes enough very basic food for a day and will not be supplimented with other food.

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

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

- 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.

- 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 07 868 6274 or call / text 021 215 1154 if you would like to discuss.

Our opening hours are Monday, Tuesdays, Wednesday & Thursdays 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 be valid in 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 "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*

Have you had a food bag 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.

How many people is this food food bag for?*

How many are adults 18+?*

How many are children under 18?*

NOTE: If you work for an agency and are assisting or applying on behalf of a client , please add your supporting comments here.

Pet food

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

Applicant Signature

Review process - click "Review" forSubmit button at bottom

Review

How many food parcels been given in the past?

How many emergency bags been given in the past?

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?

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

ApprovedDeclined

Food parcel declined - comment why

FORM PRINTED AND FILED

YesNo

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.

Foodbank Thames - food bag application

Two admin to complete to sign off