Apply for Assistance
(Fill out this form)
Please note, current students must go to the Student Nutrition Access Center (SNAC) on the campus of USU. If you have kids you are able to come to the food pantry.
Tell us about yourself
Required field!
First Name*
Required field!
Middle Name
Required field!
Last Name*
Required field!
Gender*
Required field!
Email*
Required field!
Phone*
Required field!
Address*
Required field!
City*
Required field!
State*
Required field!
Zip / Postal Code*
Required field!
Country*
Required field!
Date of Birth (mm/dd/yyyy)*
Required field!
Ethnicity*
Required field!
Tell us about your housing situation
Required field!
Rent/Month ($)*
Required field!
Own ($)
Required field!
Share ($)
Required field!
Subsidized ($)
Required field!
Are utilities included?
Required field!
Name of Landlord*
Required field!
Tell us about your family
Required field!
Household Type
Required field!
Spouse Name
Required field!
Spouse's Date of Birth (mm/dd/yyyy)
Required field!
Does your spouse work?
Required field!
Additional Family Members: (Please include their name, age, birthday, gender, and if they have a disability)
Required field!
Tell us about your finances
Required field!
Employment Place*
Required field!
Hourly ($)*
Required field!
Hours/week*
Required field!
Monthly Gross Income*
Required field!
Are you recieving other assistance?*
Required field!
Please upload a Check Stub and Proof of Address. (Proof of address must be Utility Bill or Rental Contract.)*
Required field!
By signing this form, I acknowledge that the food I receive from the Cache Community Food Pantry is donated, sorted, shelved, and bagged by volunteers.
I also recognize that there may be some foods present that may be past the expiration date and it is my choice to use them or not.
Therefore, I release the Cache Community Food Pantry, its volunteers, Community Partners, and any donor, from any claim associated with the products provided to me.
Required field!
Required field!