Summer's Sunshine

Request for Emergency Food Assistance

This form is for individuals and families experiencing an immediate, urgent food shortage. If you are unable to provide food for yourself or your household right now, please complete this application so we can respond as quickly as possible.

Please note: Once an emergency food assistance request has been fulfilled, another request cannot be considered for a period of 2 months.

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Your request has been received!

Thank you for contacting Summer’s Sunshine! A member of our Assistance Request team will reach out shortly.

Applicant Information

First name

Last name

Phone number

Preferred Method of Contact

Mailing Address

Household Information

This information enables us to make sure the amount of aid we supply is enough to support all in need and helps us quantify our impact at the end of the year (i.e., be able to put a number to how many people we helped in a year).
This info is never shared with any other parties and is never used to determine whether aid is needed.

Number of people in household

Number and ages of children in household

Housing Situation

Household Income

Other public assistance received (select all that apply)

SNAP WIC Food pantries Other

Need-Specific Details

Please describe your hardship and how Summer’s Sunshine can help address your urgent need.

Prior Assistance History

Have you received assistance from us before?(required)

Yes No

If so, when and for what?

Referral/Discovery

How did you hear about us?

Consent & Signature

Do you consent to be contacted?(required)

Yes No

I attest that the information provided is accurate