If you have a client in need of our help, you may submit a referral request online through the web-based form below. If you are unable to submit a form through the web form, you can fax a paper referral form (found below) to the number listed on the form. In both cases, you will be required to present identification when picking up the items and a waiver/ affidavit of income form signed by the client.
If you submit an web form, you will be required to have a waiver/ affidavit of income signed by the client. You must bring this form when you pick up the items.
Caseworkers will be contacted when the referral has been reviewed and notified of a time for pick up when it is approved. Pick ups generally are scheduled Tuesdays and Thursdays from 10am to 12pm at our distribution office. DO NOT COME FOR PICK UP UNTIL YOU HAVE BEEN NOTIFIED THE REFERRAL WAS APPROVED. Items must be picked up within two weeks of the approval or they will be re-shelved.