Register for a Lake County Food Drive-Thru

Choose a Drive-Thru*
Distribution Information
I have read the statement written above and will follow the rules.*
- I Agree
Self-Declaration of Eligibillity
By clicking the box below you are confirming that your household makes below 230% of the Federal Poverty Line for your household size.*
Example: below $49,059 per year for a family of three
Click here to view a detailed table to determine your eligibility.
- I Agree
Registration
First Name*
Last Name*
Phone*
Email
Your Age*
Address*
Geocoder
Place Name
Street Number
Street Name
Street
City
County
Zip
Address
Formatted Address
Latitude
Longitude
Please tell us how many people (including you) live in your household who fall into the following age groups:
Seniors
Age 60+
Adults
Age 18-59
Children
Age 0-17
ADULTS*
TOTAL*
How did you hear about this distribution?
- Social Media
- TV/Radio News
- A friend/family member
- I called the Food Bank
- I called 211
- I saw a flyer
The information that you have supplied will be added to the Food Bank's client intake system after your visit.
You can read our privacy policy here.
Please fill out all the above fields to see the REGISTER button!
Name
This field is for validation purposes and should be left unchanged.

Self-Declaration of Eligibillity