referral form

Do you know a food service employee experiencing an unanticipated crisis?

If you know someone in need, please let us know. We will reach out to you or the person in need directly after you complete the Assistance Inquiry Form. Please let the food service worker you are referring know that a case manager will be in touch with them in one to two business days.

All information submitted will remain confidential and will only be discussed with the applicant.

Please note that this form only starts an application. We must receive documentation such as a personal statement detailing the hardship, work missed, proof of employment, copies of bills and financial worksheet as part of the full application process.

Read more about our programs.