Client Registration Form

For New Clients

Families/Couples/Singles in need of food assistance may apply for support by registering at the Food Bank on Tuesdays and Saturdays from, 10:00 am until 2:00 pm, or you may complete the online application form or right-click to print it and then bring it with you when you come in person.

Emergency Hampers

If times are tough and you cannot wait for Hamper Day, which is the second Tuesday of the month, you can submit an Emergency Hamper Application form through this site. We will then contact you for a time to come into the food bank, normally on a Tuesday or Saturday. The rest of the time we are closed.

Instead of an Emergency Hamper, we suggest just coming by Tuesday from 12-1 pm, come during that time and we can offer you extras then, and each week after that as long as you need our services.

Is this a New Client Application or an Emergency Application?

New Client

Emergency

Name

First Name

Last Name

Address

Phone Number

If no number place a contact number

Your Birthdate

How many adults residing with you?

Only Include those you are responsible for

Name and date of birth of other adults in the house

How Many Children?

Names and Birthdates of children

Identify your source of income

Reason for request

Medical Conditions (If any)

Include Any Allergies

Your Email

RECIPIENT UNDERSTANDING AND DECLARATION OF INFORMATION

Declaration * I understand that I am assigned a time to come in on hamper day, or I have called in the night before in order to get a hamper the following day. Unexpected drop-in is not encouraged and may result in a request to return at another time. Emergency situations are on a case-by-case basis and requires an appointment.. A FOOD HAMPER MAY CONTAIN: A "best before" or "use by date" that has expired *canned food may be dented; canned goods are good past their expiry date for up to 4 years I AGREE to accept ANY risk associated as noted above however, if there is a concern, it is suggested you discard these items. I DECLARE that the information given is truthful and that Misrepresentation of any information may result in being dismissed from using the LUMBY Food Bank. *Should questions arise based on the information provided, a request for further clarification may be requested. The LUMBY Food Bank reserves the right to verify the information provided. The LUMBY Food Bank may contact other area Food Banks to ensure that there is no overlap of services. I agree to the Recipient Understanding and Declaration of information.

I agree

Hampers, Emergencies and Extra’s

Our weekly “Extra’s” are on Tuesdays between 12:00 and 1:00. This is where we distribute any extra fresh produce, meat, and product that may have come in the previous Saturday through our food recovery program.

Our “Monthly” regular Hamper is on the Second Tuesday of the month… between 12:00 and 1:00. During this hamper week you will go home with anything we have that’s fresh, including milk, margarine, and eggs, as well as canned veggies, pork & beans, canned fish, Mac & Cheese, Pasta, Juice, and cereal, as we have supplies. We will offer you some frozen meat as well. it’s during this special hamper day that you are able to request a couple of the other things you may need that we have on hand, such as condiments, soap, sugar, coffee, peanut butter, jam, and pet food are examples.

For an “Emergency” hamper we ask that you call ahead to provide the information necessary or fill out the online application, then come in on Tuesday to do a pickup. This way you can get any fresh items we have. After Tuesday fresh veggies will be gone.

If we’ve got it, we are happy to share it! Please click on the Application form from any page, fill it in, print it off and bring it in or just submit it!