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Food pantry intake form 2025

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The document is a client intake form for the Cupboard of Kindness Food Pantry, designed to collect essential information from individuals seeking food assistance. It includes sections for personal details, household composition, income, proof of identity, ethnic origin, and questions regarding past assistance and hardships. Additionally, it inquires about dietary restrictions and allergies, as well as the need for referrals to other support services.

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Click ‘Get Form’ to open the food pantry intake form in the editor.
Begin by entering the date at the top of the form. This helps us track your application accurately.
Fill in your name, address, and telephone number in the designated fields. Ensure all information is correct for effective communication.
Indicate the number of individuals in your household, specifying adults, children, and seniors. This information is crucial for assessing your needs.
Provide your monthly household income and select proof of identity from options like a driver's license or utility bill.
Answer questions regarding your ethnic origin and previous assistance received. These details help us understand your background better.
Respond to inquiries about recent hardships, medical costs, and public assistance applications to ensure we can provide appropriate support.
Specify any dietary restrictions or food allergies within your household to tailor our services effectively.
If you would like referrals for additional assistance services, check the relevant boxes provided on the form.
Finally, review all entered information for accuracy before submitting. All data will be kept confidential.

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