Proxy Form


DO YOU NEED SOMEONE TO PICK UP FOR YOU? If you need someone to pick up on your behalf, you must provide their name, your name, and your signature below.

DO YOU NEED TO PICK UP FOR SOMEONE ELSE? If you want to be able to pick up on behalf of someone else, you must provide their name, your name, and your signature below.

Proxies are allowed for sick and shut-in individuals only. Individual food recipients must designate their proxy in writing on an annual basis. After designating the proxy, the proxy may sign for food at ongoing food distributions.