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Registration / Proxy Forms

As of September 2019 we implemented a new intake software at ALL of our mobile food pantry program locations. All families are REQUIRED to re-register and bring a Photo ID when registering, and will be required to bring a photo ID for all distributions. The address listed on the form must match your current address on your photo ID. If the photo ID does not have your current address, please bring a piece of mail or any additional documentation to prove your current address. As a reminder, PHOTO IDs will be required each month during registration beginning the month of September.

Clients will be registered per household therefore, family members living under a same address must define the apartment number, floor number, etc. in order to register their household. In order to help speed up the re-registration process, we ask that you please complete a questionnaire ahead of time, and bring it with you during the next Mobile Food Pantry program distribution. This re-registration form will be only completed once. Click here to download the Questionnaire and Disclaimer in Word or as a PDF (disclaimer to be signed electronically at Mobile Pantry distribution but can be read ahead of time).

Let us reassure you that once you are registered at any of the locations, these questions will not be asked again unless we need to update your information. Once initially registered, the intake registration process will be much easier at any of the other locations.

Proxies must also present an ID for the client they are representing as well as for themselves. New Forms must be signed by clients and their proxy. Click here to download the Proxy Form.

Acceptable forms of ID are: STATE ID, Driver’s License, Passport, Student ID, Utility Bill.

We appreciate your patience in this process.

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Many thanks to the following funders for their grant support of the Gemma E. Moran United Way/Labor Food Bank and the Mobile Food Pantry program:

Bodenwein Foundation, Centreville Bank, Chamber of Commerce of Eastern Connecticut, Charter Oak Federal Credit Union, Chelsea Groton Bank, Citizen's Bank, City of New London Community Development Block Grant, Community Foundation of Eastern Connecticut, Dime Bank, Dominion, EFSP – CARES, Emergency Food and Shelter Program, Eversource, Frank Loomis Palmer Fund, Jewett City Savings Bank, Ledyard Rotary Foundation, Liberty Bank, MDA-UAW Local 571, Mystic Rotary, New London Telephone Employees' CSF, Niantic Rotary, Pfizer Inc. ShopRite, and Swindells Charitable Foundation