Brooklyn Pratt Pantry Intake Form (new visitors)
Please fill out this form ahead of your visit to the Pratt Pantry. All answers will be kept confidential and no answers will be used against you to restrict access to the Pantry. There will be space for questions and concerns at the end.

By submitting this survey, you also agree to the Pratt Pantry Terms and Conditions (see here:  https://docs.google.com/document/d/19DUf9e-UZIE7zfN11aCz_4s61ooHIiUfJPT4JD_SCqY/edit?usp=sharing) 

The questions regarding identity associated with race, gender, and sexuality are entirely voluntary and answers are completely confidential.  Aggregate data in response to these questions is used to support the ongoing need for a food pantry and to determine how Pratt can better serve its various student populations.

If you have already completed this form but not during this current academic year, please complete it again. If you have completed it during the 2023-2024 academic year, you are not required to complete it again. 
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Email *
Please enter your Student ID number *
Which school do you attend? *
Are you an undergrad, graduate, or non-degree student? *
Household Size (here at Pratt/in NYC. Do not include your family if you do not live with them full time. Include roommates if you share food) *
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Adults
Children
Seniors
Do you share meals/food with people in your home? *
How did you hear about the Pratt Pantry? *
Do you identify as a person of color?
Clear selection
What is your gender?
Clear selection
Do you identify with any of the following identities: Lesbian, Gay, Bisexual, Trans*, Queer, Intersex, Asexual and Gender Nonconforming (LGBTQIAGNC)
Clear selection
Are you a parent, guardian, or caregiver? *
Are you a military veteran (In the US or your home country)? *
Are you an international student? *
Do you have a Federal Work Study Award? *
Do you receive any sort of financial aid? *
How do you pay for school supplies, necessities, and recreational activities? (check all that apply) *
Required
Food insecurity is defined as the lack of reliable access to sufficient affordable and nutritious food. What are the main barriers to food security for you? (check all that apply) *
Required
Due to lack of money, I have skipped meals: (check all that apply) *
Required
What items do you financially prioritize over food? (check all that apply) *
Required
Where do you live? *
During my time in college, I have had difficulties paying for housing, food, and school supplies due to costs associated with medication and health care *
Do you receive (check all that apply) *
Required
If you are an international student... (check all that apply) *
Required
What kinds of foods do you wish the Pratt Pantry supplied?
Other than food, is there something else you wish we would provide?
What else should we know about you? Any additional comments? (Remember, all answers will be anonymous and used solely to improve the quality of services for the community)
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