Watchtower Community Church Monthly Food Pantry Registration Form

Please fill out the following information to register for assistance. Your responses will remain confidential and will only be used to help us serve you better.

Please Note: Food pick is once per month and distributed after church.

Your name *

Last name

Email address *

Date of Pickup

Address

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

Phone number

Phone type

How many Adults in your family

Total Number of People in Household

How many children in your family

Do you have any allergies?

Dairy-Free

Nut Allergy

Cooking Access

Stove

Refrigerator

Microwave

Limited/No cooking access

Pantry Use

First time receiving food from this pantry

Have received food before

Would you like to receive information about any of the additional resources or services available?

I would like prayer

I would like information about church services

I would like information about community resources

Statement and Signature:

I confirm that my household is currently in need of food assistance. I understand that food box distribution takes place on the third Sunday of each month between 12:00 PM and 1:00 PM, and I acknowledge that I am responsible for picking up the food box during this scheduled time.

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Watchtower Community Church
ladychrystall@watchtowercommunity.com
3368097902

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