JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Monroe GEARS Food Shelf
We are excited that Monroe is offering our own food shelf! This is available to all of our Monroe families. To receive food/basic needs please fill out this form. You can request to come and shop at our food shelf or we can put together a bag(s) food for you if you do not want to come into the school.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Students First Name
*
Your answer
Students Last Name
*
Your answer
Parent/Guardian's Name
*
Your answer
If we need to contact you, what is the best number to reach?
*
Your answer
How many people are in your household?
*
Your answer
How would you like to receive your food?
*
I will come and shop myself at the food shelf. Please call me to set up a date and time.
I would like YOU to shop for me and I will come and get it at school. Please call me to set up a date and time to pick it up.
Is there any food restrictions we should be aware of?
*
Your answer
If you want us to shop for your family. What is your family in need of? We will fill the bags to the best of our ability.
*
Food
Tolietrie items (toothbrush, toothpaste, shampoo/conditioner, body wash, toilet paper)
Cleaning items (dish soap, laundry items, Clorox wipes)
Baby items
Not applicable. I will shop myself
Other:
Has your family applied for the schools free/reduced lunch program?
*
Yes
No
I am not sure
I would like to apply, but need help
Does your family receive the Every Meal Program? It is a food bag that comes home in your students backpack every Friday.
*
Yes, we are signed up
No, I am not interested in it
No, but I would like to sign up
I would like information or support with SNAP assistance.
*
Yes, I'd like a support staff memeber to call me with more information
No, I'm good
No, I already know about it or receive this resource
Other:
Are there any resources we can assist you with?
*
School support
Financial
Mental Health
Shelter
Utility Assistance
Clothing/Winter Gear
Medical
Holiday Help
Other:
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Anoka-Hennepin School District.
Report Abuse
Forms
