Registration Form | Norwood Food Pantry

CLient Registration

Use this page to apply as a New Client or update your current documentation based on our annual requirements.

The Pantry is open to residents of Norwood and Westwood who meet eligibility criteria.

The Pantry is located at the back of the Grace Episcopal Church, 150 Chapel Street, in Norwood.

No one may shop at any other Pantry if they are shopping here. The registration paperwork is reviewed, recorded in the pantry’s confidential database, and clients keep their papers. No client information is provided to anyone outside of the pantry.

You may use the form below, or register with the Intake Coordinator in person when you visit the Pantry. They are available during pantry hours and will help you complete the process.

If you have questions, or cannot fill out the form online, please speak to the In-take Coordinator or the Executive Director (available in person on Saturday mornings) or call us at 781-291-3663. We will be happy to assist you.

Food Pantry Registration

First Name

Last Name

Verify Email (enter email again, so we can make sure there aren't typos)

Phone

Birthdate

If you are not comfortable with English, what language(s) do you speak?

Street Address (including apartment/house number)

City (Norwood or Westwood Residents only)

State (Massachusetts only)

Zip code

Family Members

If you do not have additional family members, you may skip this section

All family members living in your house must be registered so we have an accurate household count for your shopping list.

Family Member 1 (First and Last Name)

Family Member 2 (First and Last Name)

Family Member 3 (First and Last Name)

Birthdate

List Additional Family Members Names and Birthdates

Required documentation

We need ONE of the following documents as proof that you live in Norwood or Westwood:
* Bank Statement
* Benefit Statement
* Driver License
* Earnings Statement with address
* Mass State ID
* Mortgage Statement
* Rental/Lease Agreement
* Utility Bill

File upload. Take a picture of one of the documents listed above, then upload that image. Make sure the image is in focus, and close enough to read the information required.

Upload File

Drag File or Upload from your device

We need a copy of an item for ALL Adult members in your household from the first list OR the second list.  

EAEDC (Transitional Assistance to elderly, disabled, and children)
TAFDC (Transitional Assistance to families with dependent children)
SNAP Benefit Letter (available on SNAP website)
SSI (Supplemental Security Income)
SSDI (Social Security Disability Insurance- Not the SS Card)
WIC letter (Special Supplemental Nutrition Program for Women, Infants and Children under the age of 5)
Norwood or Westwood Housing Assistance (section 8)

Provide information regarding ALL income received by ALL adult members of your household. A statement or pay stub including total pay amount (year to date). from each source is required.

Salary/Wage statement - includes total pay amount, taxes paid, etc.
Alimony
Child Support
Pension
Social Security Statement (Not the SS card)
Unemployment Benefits
Veteran Benefits Statement
Workers Compensation
Other Income

For ALL Adults in the household, a photo of each document for every adult is required. Do not send pictures of your Social Security Card, WIC card or Mass Health Card.

Take a picture of ONE of the documents listed above, then upload that image. Make sure the image is in focus, and close enough to read the information required.

Upload File

Drag File or Upload from your device

Upload Additional Documentation if necessary

Upload File

Drag file or upload from your device

Click here to read the Client Guidelines and Rules

I agree to the Client Guidelines and Rules.

Signature (Use your mouse or finger to draw your signature)

Thank you!