CCCC Food Assistance Request Form
Central Carolina cares.  While the college is closed due to COVID-19, CCCC will provide assistance and/or connect students to community resources related to food security. Please complete the following form to help us understand the severity of your need. We will be in contact about all requests, but we ask these questions so we can ensure those in the most severe situations can be prioritized and served first. This form is confidential and the information shared will only go to individuals absolutely necessary to help address your need.
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Full Name (as it appears on student ID) *
CCCC Student ID Number
Phone Number *
Email Address (unless you say otherwise, this is how we will contact you) *
Please select the option that best describes your current food security level: *
Not counting yourself, how many adults over the age of 18 live in your household? *
Not counting yourself, how many minors under the age of 18 live in your household? *
Is there anything else you'd like us to know?
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