Food Pantry CLIENT INFORMATION FORM - Resurrection Life 2026

1. Click ‘Get Form’ to open the Food Pantry CLIENT INFORMATION FORM in the editor.
2. Begin by entering your Client ID number in the designated field for office use only.
3. Fill in your Last Name and First Name, followed by your Street address, City, State, and Zip code.
4. Provide your Phone number and Date of Birth. Indicate your Sex by selecting M or F.
5. Enter the Total Number of people in your Household and list all household members in the space provided.
6. Specify your Total Household Income and circle whether it is per week, month, or year.
7. Select the Source of Income that applies to you from the options listed.
8. Complete the Other Support section if applicable, including any assistance like Food Stamps or Medicaid.
9. Indicate your Household Type and Education level by selecting the appropriate options.
10. Fill out the Household Member Information section for each member, including their Name, DOB, Relationship, and Authorization to Pick Up (Auth to P/U).
11. Finally, review all information for accuracy before signing at the bottom of the form. Ensure you date your signature as well.

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