REGISTRATION FORM

Food Pantry Participation Requirements

If you are not currently an SWB Delivers program participant, please call (510) 833-2154 to speak with a representative before submitting this form.

Participants must be 18 years of age or older.

Food is limited to one pickup per household per distribution date. Only one adult household member may register for and pick up food on behalf of the entire household. Multiple members of the same household may not register separately or receive separate food distributions.