StoryShare for Mobile Food Pantry Guests

Our neighbors should have access to the food they need and prefer.

You can help by answering some of the questions below about your experience with food assistance.

Name*

First NameLast Name - WE WILL NOT SHARE THIS

City/Town*

Phone Number*

WE WILL NOT SHARE THIS.Format: (000) 000-0000.

Email*

WE WILL NOT SHARE THIS.

Birth Year*

WE WILL NOT SHARE THIS.

Preferred Communication:*

Phone CallEmailText

Do you currently receive free food from Connecticut Foodshare mobile food pantries?*

YesNo, but I have previously

How long have you been using mobile food pantries to supplement your groceries?

Others in my household that receive this food (check all that apply):*

My minor children (please provide ages of all children)Others (please provide their relation to you and their age)

Please tell us the ages of the minor children in your household that rely on food from mobile pantries:*

Please tell us about the Other people in your household that rely on food from mobile pantries:*

How did you find out about Connecticut Foodshare mobile pantries?

How has visiting the mobile food pantries helped you and your family? (i.e., get healthier food, free up money for other bills or medicine, etc.)

What foods do you and your family/household members look forward to from the mobile food pantries?

What meals have you made recently with food you received?

What does receiving this food mean to you?

If you choose to meet with Connecticut Foodshare in person, you will receive a grocery store gift card.

Are you interested in meeting with a member of Connecticut Foodshare staff?*

Yes, I'd like to meet with Connecticut Foodshare at my mobile pantry location to share my story in person and be photographed.No, I do not wish to meet in person to share my story.

Will you allow us to photograph you at the mobile food pantry?*

YesNo

Do you give permission to have your children photographed at the mobile food pantry?*

YesNoN/A- I DO NOT HAVE MINOR CHILDREN

Please use the link below to find the name or address of the Connecticut Foodshare Mobile Site you would prefer to meet at, and then enter it in the box below:

Connecticut Foodshare Mobile Pantries

Your preferred mobile pantry site name/address:

I give Connecticut Foodshare permission to share my Mobile Food Pantry Experience from this form (we will never share your last name, phone number, email.)*

Connecticut Foodshare deeply appreciates your willingness to share your story! We will reach out shortly - if you have any questions in the meantime, please email our Director of StoryShare, Merry Renduchintala, at merryr@ctfoodshare.org.

StoryShare

About You

Your Mobile Food Pantry Experience

Share Your Story