Sign up form | Lovell Area Food Pantry

New Client Registration Form

Name

Birthday

Street Address

City

State

Postal / Zip code

Phone (Cell)

Phone (Home)

Best way to communicate:

Cell phone - contact

Home phone - contact

Text - contact

E-Mail - contact

Household Information

Are you receiving food distribution from any other source?

Yes, other sources of food

No other sources of food

The undersigned participant certifies that the information / answers provided are complete and true.

You further agree to the following:

You understand that this food pantry is to be used as an emergency resource only and is meant to supplement any additional assistance or resources you may receive.
Food is provided on a FIRST COME, FIRST SERVE basis and you relinquish this food pantry and the Community Food Banks of ME of all liabilities of any nature whatsoever and accept the food "AS IS" and at your own risk.
There is no guarantee to the amount or type of food product given.
You will not sell the food or non-food products or exchange / barter food or non-food products for services.
Inappropriate behavior such as profanity, verbal abuse of staff or any other disruptive behavior is prohibited. Any such behavior may result in the suspension or termination of your privileges at this food pantry.

The Lovell Area Food Pantry is run by volunteers within the community and its sole purpose is to help distribute food to those in need. We appreciate your patience and cooperation during our business hours.

Staff will bring your food to your vehicle.

We commit to treating all who come here with respect and dignity and we expect the same in return.

We reserve the right to turn away anyone who is verbally or physically abusive or have threatened harm to staff or other clients. Thank you.

PLEASE SIGN AND DATE BELOW, CLICK ON "I AM NOT A ROBOT" BOX AND PRESS THE SUBMIT BUTTON WHEN COMPLETE