Feed Our Neighbors Application

Check the income eligibility above before you apply. After you submit the application, it will take approximately 10 days to process. Please do not call our office; email us at info@uwsle.org if you have any questions.

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Contact Information

First Name *

Last Name *

Date of Birth *

Month

Day

Year

Mailing Address *

City *

State *

Postal Code *

Phone number *

Email *

Did someone in your household have a reduction in work hours due to COVID-19 or other disaster/emergency? *

Yes

Did someone in your household lose a job due to COVID-19 or other disaster/emergency? *

Yes

Please Explain Your Hardship due to income loss from COVID-19 Pandemic or other disaster/emergency

Are you receiving SNAP benefits? *

Yes

Are you receiving SSI benefits? *

Yes

Are you receiving Unemployment Benefits? *

Yes

Most Recent Employer *

What is the total annual income of all earners in household? *

Number of Adults in Household? *

Number of Children in Household below the age of 18 *

Upload Proof of income from all earners in household (Choose one option) *

First page of 2021 tax return (for all earners if filed separately)

2021 W2 for all earners

Last paystub for all earners (+ payment frequency for each)

Social Security Administration 1099 or 1042-S form

Proof of income from all earners *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc.

Photo I.D. (driver's license, state-issued ID, or passport *

Upload Photo ID
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc.

CAPTCHA

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