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Request Food Assistance

Assistance Request • Groceries • Hygiene • Technology

Unified Request Form

Submit one request for groceries, personal care items, and (when available) refurbished devices such as laptops, desktops, tablets, and printers. Requests are reviewed based on inventory and program capacity.

General grocery support

Personal care essentials

Technology for learning (limited)

Confidential review

Important

  • Items provided are based on availability.
  • We do not customize food selections.
  • Technology is limited and prioritized for learning needs.

Tip: Photos help speed up approvals for furniture and bulk donations.

    Personal Information





    Household & Timing





    Requested Items (Select all that apply)

    Groceries & Pantry (General)

    We provide general donated items and do not customize selections.

    Personal Care & Hygiene

    Baby Essentials (Limited)

    If requesting diapers, include size in notes.

    Technology (Refurbished • Limited)

    Technology support is limited and prioritized for students and learning needs.

    Student Info (If requesting technology)

    Add grade level and purpose in the notes (optional).

    Notes (Optional)


    Allergy & Safety Notice (Important)

    We distribute general donated food and personal care items. We do not customize selections and we cannot guarantee products are free from allergens (including, but not limited to, nuts, dairy, gluten, fragrances, or other ingredients). Recipients must review ingredient lists and product labels before use. If you have severe allergies, please use caution.

    I understand that items are general donations and I am responsible for checking labels/ingredients and using items safely.

    Privacy


    Your information is used only to review and coordinate assistance. We do not sell your personal information.



    Important: Submitting this form does not guarantee assistance. Support depends on funding, inventory, and program capacity. We respond as quickly as possible based on volume. Urgent requests are prioritized when capacity allows.

    What We Can Provide

    Based on availability:

    • Groceries & pantry items
    • Personal care essentials
    • Baby essentials (limited)
    • Refurbished devices (limited)

    Tip: In the notes, list your top 3 priorities so we can pack faster.

    Technology Requests

    Devices are limited. If you are requesting a laptop/desktop/tablet, tell us the learning purpose in the notes.

    Response Time

    We respond as quickly as possible based on volume and inventory. Urgent requests are prioritized when capacity allows.