This is the  LIFE Station Pantry Registration Page.
 
This page is for requesting delivery of food resources.
 
If you can pick up resources during walk-up hours at the LIFE Station ( Monday thru Friday 11-3) please do and that would be greatly appreciated. We may have additional resources for walk-up.
 
LIFE Station delivery area spans 43605, 43609, 43619, 43616 (western half), 43608, 43604, 43607, 43606, 43614, 43611, 43612,  43613, and 43620. 
 
Should I request delivery? 
 
If you need delivery due to health concerns or transportation issues please do not hesitate to request delivery. We definitely want to help you. Fill out the form or call 419-242-3340 and one of our operators will fill out for you.  Your delivery will usually arrive up to the next business day. We do require a two day window for delivery. Please plan on being home and available by phone for confirmation. 
East Toledo details:
 
43605 deliveries will be scheduled with help from New Heights Fellowship Baptist Church of East Toledo which meets at 255 Heffner in Toledo. If you are in Toledo and Looking for a new church home please give them a try. 
 
Please know that we are simply trying to be good neighbors and we want to assist with resources.
 
Households with minor children:
 
If you are feeding children in your home there is a form that we would like to get signed which allows us to deliver more resources that are especially kid-friendly. This form will need signed at each delivery stating that your income is at or below 200% of the federal poverty limit.
 
Be home to receive: 
 
You must be home to receive your delivery for the two day window. If you fail to receive it there are no guarantees of redelivery.  We will try to reschedule after other deliveries that have already been requested. Failing to receive a requested delivery multiple times will be grounds for denying all future requests for delivery for a given household. If you are going to be out and about stop by the life station and pick up your free groceries. 
 
Outside our area:
 
Outside the above listed zip codes deliveries are still possible but manpower and resources are somewhat more limited. Please seek a pantry that is functioning in your area. If there are none, call us. We will look into it and do what we can. 
 
Twenty-Eight days after a LIFE Station delivery or receiving resources from the Life station by picking up from the front door, you may place another request for delivery. 
 
You may not fill out the form for others although you may help someone else fill out the form for themselves. Caseworkers who want to arrange for delivery to a client should reach out to the LIFE Station via telephone directly prior to filling out this form for any clients. Registered Case workers may then fill out multiple forms as needed after authorization. Please do fill out your contact information for follow-up. 
 
If you call 419-242-3340 one of our operators will fill out the form for you  and answer any other questions you may have. If an operator is not available when you call you will get voice mail. Please leave a message and wait for a call back. You should receive a call back within 24 hours on weekdays. We will attempt to deliver your groceries on or before the next day whenever possible. 
I am eligible* I am a new client   It has been 28 days since I last requested goceries from Life Station   
Mark here the reason delivery is needed instead of picking up groceries*
First Name, Middle Initial, Last name*
Address*
Address Line 2 (Apt./Lot/etc.)
City*
County*
Zip Code*
Apartment Complex Name *
Email Address*
Birthdate*
Marital Statues*
Gender*
Voluntary Identify as Veteran*
Cell Phone Number*
Can we Send you Texts?* Yes Texts   No Texts   
Total number of people in household*
Total number of people in household 0-5 years old*
Total number of people in household 6 years old to 12 years old*
Total number of people in household 13 years old to 17 years old*
Number people in houshold between the ages of 18 and 59*
Number people in household 60+ years old*
Full name of first additional person *
Relationship of additional person
Birthdate of additional person
Full name of Second additional person *
Relationship of Second additional person
Birthdate of Second additional person
Full name of third additional person *
Relationship of third additional person
Birthdate of Third additional person
Full name of Fourth additional person *
Relationship of fourth additional person
Birthdate of fourth additional person
Full name of Fifth additional person *
Relationship of fifth additional person
Birthdate of fifth additional person
Enter the full name, relationship, and full birthdate of any person in the household not yet listed*
Please enter the name of your home church if you have one (not required)
If you have a home church please note how often you participate (Not required) Never   Weekly or more   Other   
Decline to answer   
Identify as a Christian*
Please Send Mail-in Bible Study for all members of the family (FREE)*
Please give me access to free streaming service with 10,000+ Video Bible studies AND 2500+ Children and family-friendly shows
Do you need a new church home?*
Do you need encouragement?*
Certain Additional Food resources for households with minor children (partial custody included, etc.included-not sure, pleas ask)* I understand that I will need to sign a form at each delivery to state that my household income is at or below 200% of the federal poverty limit in order to receive certain additional food resources   There are no minor children as part of the household    
Please put your full name here to attest to accuracy of all information. If you are filling this out for someone else, enter your name and cell phone number here. You are responsible to see that ALL questions are presented to the client and for accuracy*
If you are a caseworker filling this form out for a client please enter your organization information here. Please ensure all clients have had the opportunity to answer ALL questions.


This is the  End of the Registration Form. Clicking the SUBMIT button above is the final step. The surveys that follow are optional.
 
Which is more important, A Christian's First-time decision for Christ or ongoing growth as a Christian?
To Deny One Self (as Christ Commanded) means
 
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