Food 4 Vets will distribute food on Saturday, March 20 between 10am and Noon. Help us by filling out the registration form below. All information is strictly confidential and is only used by HKJFP.

The HKJFP address will be displayed to you when you click submit at the end of this form. If you have any questions about this day or questions about the food pantry, contact Erica at esteen@jfsstl.org. Please include Food 4 Vets in the subject line.

If for any reason you are not capable of filling out the form, you may call Ken Weintraub MSW at 314 680 2905 or email to ken@thekaufmanfund.org to register .

The Kaufman Fund and HKJFP want to make sure you and your family have food in your pantry.

All fields are required.

First Name:

Last Name:

Branch of Service:

Gender:

Male      Female

Date of Birth:

Month: Day: Year:

I do not have a residence at this time.
Total Number of people living in your household including your self.

Email(optional):
Home or Cell Phone Number:
 
Mailing Address:
 
City:
 
State: Missouri Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip:
 
What is your Nationality/Race?: Select One African American or Black American Islander or Alaskan Native Asian Hispanic or Latino Multi-Racial Native Hawaiian or Pacific Islander White Other Did Not Disclose  
Religion: Select One None Baptist Buddist Catholic Christian Hindu Jewish Lutheran Muslim Protestant Pentecostal Other  

Do you keep Kosher?:

Yes      No

How did you hear about this food pantry(HKJFP)?