Request Help from the Food Pantry (SEC)
Request Help from the Food Pantry (SEC)
Food pantry assistance is available for JWCC students and their families.
Name
Name
*
First
Last
J# (your student ID number, e.g. J000XXXXX)
*
Cell Phone
Cell Phone
*
-
###
-
###
####
JWCC Email
*
How many people are in your household?
*
What kind of assistance do you need?
*
What kind of assistance do you need?
Food
Toiletries
Both food and toiletries
Any allergies?
*
Any allergies?
Yes
No
Please list the allergies.
*
What food are you in need of? Check all that apply:
What food are you in need of? Check all that apply:
Pasta
Canned Tuna
Canned Chicken
Canned Fruit
Canned Vegetables
Cereal
What toiletries are you in need of? Check all that apply:
What toiletries are you in need of? Check all that apply:
Deodorant
Shampoo
Soap
Toothpaste