Family Assistance Request Form

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Hoosier Helpings Food Pantry and Community Outreach program is for students enrolled in a Hoosier Academies Network of Schools school. Families should note that you must be available to pick up items from our location at 5650 Caito Drive. Indianapolis, IN 46226. If you are unable to pick items up, and would like assistance finding resources in your local community, please call 4-1-1 for information.

Hoosier Helpings has assistance to offer, but first we need some help from you. Please fill out the form thoroughly so we can get the process started.

First & last name *

Please list the names and grade levels of enrolled students *Please note that you must have at least one student enrolled in Hoosier Academies or Insight of Indiana to be eligible to receive assistance.

Address *

Phone number *

E-mail Address

Number of family members living in the home *

Items needed *

Food

Toiletries

Clothes

Items for children younger than 1 year

Dog Food

Cat food

Required

If you have indicated a need for clothing, please list sizes for items needed. (i.e. Girls size 14 pants)

Is this a recurring need? *

Yes, this is a recurring need

No, this is a one time need

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