Welcome to the LIFE Station Pantry Registration Page.
You may request delivery here or register in advance for pick up services. 
 
Delivery or pick up services?
To be eligible for delivery you must meet the following criteria:
  • Live within the city limits of Toledo (some exceptions may apply)
  • Unable to pick up due to significant health or transportation barriers
  • You MUST be home to sign for your delivery for a 2 day delivery window between the hours of 11am-6pm
  • It has been 28 days or longer since you have recieved food from the Life Station in either pick up or delivery services
If you have questions or are not sure please call 419-242-3340 and one of our call reps will help you. If we do not answer please leave a message and you call will be returned within 24 hours on weekdays.
 
Please do not fill out this form for others unless you are a caseworker or authorized representative. You may help them fill it out but ALL questions need to be asked and completed.
 
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.
 
We have additional resources to help housesholds with minor children. We must collect first name, last name and date of birth for each child residing in the home. 
 
Live within the city limits of Toledo: We deliver to any address in Toledo. We can sometimes do address in other closeby neighborhoods but this will be depend on resources and manpower and is not guaranteed.
 
Unable to pick up due to significant health or transportation barriers: We are open Monday through Friday 11am-3pm to pick up food resources and 11:30am-2:30pm to shop for clothing. If you are able to pick up please do so. If you are not able to pick up due to physical health, mental health, significant transportation issues, or other emergency situations please fill out the form below or call to schedule delivery.
 
You must be home to receive your delivery: Delivery is scheduled for a 2-day window between the hours of 11am-6pm. 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. 
 
 
Eligibility:*I am a new client   It has been 28 days since I requested food from Life Station   
Pick up or delivery? If delivery, why do you need delivery?*
First Name, Middle Initial, Last Name*
Street Address*
Address Line 2 (Apt, Lot, etc)
City*
County*
Zip Code*
Apartment Complex Name*
Phone Number*
Phone Type*
Can we text you?*
Birthdate*
Email Address*
Marital Status*
Gender*
Household with a Veteran*
Total number of people in your household (including you)*
Total 0-5 years old*
Total 6-12 years old*
Total 13-17 years old*
Total 18-59 years old*
Total 60+ years old*
First and last name of additional person 1
Relation to you
Their birthdate
First and last name of additional person 2
Relation to you
Their birthdate
First and last name of additional person 3
Relation to you
Their birthdate
First and last name of additional person 4
Relation to you
Their birthdate
First and last name of additional person 5
Relation to you
Their birthdate
First name, last name, relation to you and birthdate of any other persons in your household not yet listed*
Are you a Christian*
Do you have a home church?*
Name of church
Attendance Frequency
Do you need a new church home?*Yes   No   Prefer not to say   
Would you like a FREE Bible study that comes in the mail?*Yes   No   
Do you want encouraging phone calls/texts?*Yes   No   
Would you like FREE RightNow Media (Christian streaming service)?*Yes   No   
I understand that I have to be home to sign a form for every delivery and no one can sign for me.*I understand   I do not understand   
I understand that I must sign a form stating my household income is under 200% of federal poverty level for my household size. (We do not require proof.)*I understand   I do not understand   
Please enter your name to state that all info is correct to the best of your knowledge.*
If you are an Authorized Representative for this client and have asked them ALL questions on this form, please put your name here.
Please enter your organization/relationship, phone and email.

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