Thanksgiving Food Box Registration

Thanksgiving Food Box Registration


Thanksgiving Registration Form Header

Please complete the registration form below if you are in need of Thanksgiving food. Clients must be registered in order to receive the food box, which includes holiday food items like mashed potatoes, pumpkin, stuffing, vegetables, etc. The form must be completed by October 16 at 4:00 p.m. If you'd prefer to fill out a paper form, please pick one up during our pantry hours Tuesday, Wednesday, or Friday from 10:00 a.m. to 1:00 p.m.

Thanksgiving food will be distributed on Tuesday, November 24 using a drive-thru pantry outside JFS. After submitting the form, you will receive an email confirmation. Please bring that with you on November 24 to pick up your food. 

* Required

 New Client
 Client Recertification











 Non-Hispanic/Non-Latino
 Hispanic/Latino
 Jewish
 Don't Know
 Prefer Not to Answer

 American Indian or Alaska Native
 Asian
 Black or African American
 Native Hawaiian or Other Pacific Islander
 White
 Don't Know
 Prefer Not to Answer


 English
 Spanish
 Russian
 Arabic
 Other (please list)


 Single
 Married
 Common Law
 Living Together
 Separated
 Divorced
 Widowed

 Male
 Female
 Trans Female
 Trans Male
 Gender Non-Conforming
 Prefer Not to Answer

 Yes
 No
 Don't Know
 Prefer Not to Answer

 Yes
 No
 Prefer Not to Answer

 1st-8th Grade
 Some High School
 High School Diploma
 GED
 Some College
 Associate's Degree
 Bachelor's Degree
 Master's Degree/Post Graduate
 Vocational Certification
 No Education

 Rent
 Own
 Homeless
 Other


 Employment
 Unemployment Insurance
 SSI
 SSDI
 OAP
 Social Security
 Pension
 TANF
 Alimony
 Child Support
 No Income


 SNAP (food stamps)
 Medicaid
 Medicare


 Yes
 No





















 1/ $2126.67
 2/ $2873.33
 3/ $3620.00
 4/ $4366.67
 5/ $5113.33
 6/ $5860.00
 7/ $6606.67
 8/ $7353.33

 Yes
 No

 Yes
 No

*In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discrimination on the basis of race, color, national origin, sex, age, or disability. To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence Avenue, SW, Washington, DC 20250-9410 or call 202.720.5964 (voice and TDD). USDA is an equal opportunity provider and employer.

Power of Potential-FSN