Apply — Free Food Stockpile

Applicant information

Tell us a little about the main applicant.

First name *

Last name *

Date of birth *

Medicaid CIN ID *

Found on your Medicaid benefit card.

Phone *

Email

Street address

City / Town

Area / Region

State *

ZIP code *

Language preference

Household members

Add everyone living in your home who this may help. You can add more than one.

Eligibility & needs

A few quick questions to see how we can help.

You do not need to upload anything now. If a photo of your Medicaid card is needed, our team will help you with it when we contact you.

Does anyone in your household have a serious or chronic health condition?

Examples: Alzheimer's / dementia, renal (kidney) failure, COPD, HIV/AIDS, cancer, diabetes, a serious mental health condition, or a substance use disorder.

If yes, please specify the condition(s)

In the past 12 months, did you worry your food would run out before you had money for more? *

An answer of "Never true" generally does not qualify for services.

Are you currently receiving home-delivered meals through a NYS social services program? *

Anything else we should know?

Application received!

Thank you. Our local team will review your information and reach out to you soon to arrange your free food and meal support. If you have questions, call or text us at (845) 248-0680.

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Apply for food support

Applicant information

Household members

Eligibility & needs

Application received!