Porchlight Community Services, Inc.

Free Food Basket Application Form

Help us make this process smooth and efficient by providing clear documentation to verify your address and financial situation.

🔹 Required Documents:

A valid photo ID
At least two to three supporting documents (e.g., utility bill, pay stub, or benefits letter)

📌 Important: All documents must be clear and legible.

Once you submit the form and required documents, we’ll review your application and send an email confirmation with your appointment details. In the meantime, please visit our website to learn more about our services and location.

First name

Last name

Email

Address

City

Zip Code

Phone

What is your household size?

How many adults live with you? (Age 18+)

How many children live with you?

Which of the following best describes you?

Do you or your family members have any allergies or food restrictions? (Select all that apply)

What is your total household income (pre-tax)?

Does your income meet the Federal Income Guidelines?

What is your total household income (pre-tax)?

Acceptable proof of ID verification

A government issued ID, drivers license or passport. (Must be current and match current address), school issued picture ID

Acceptable proof of address

A government-issued ID with address, such as passport or driver’s license, government correspondence, or utility bill

Acceptable proof of income

Recent pay stub for all in household; if Unemployed, or on Government assistance, notification of award or denial letter