PBC - FOOD FOR KIDS

Do you have children, ages 0 – 18, in your household? *This question is required.

• No
• Yes

Are you receiving any of the following benefits? *This question is required.

• SNAP
• WIC
• P-EBT
• None
• Don't Know
• Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

Do you qualify for free/reduced lunch?  *This question is required.

• No
• Yes
• Don't Know

Do you need additional food for the youth in your residence at this time? *This question is required.

• No
• Yes

Are you aware of free Grab and Go meal distribution sites? *This question is required.

• No
• Yes

Do you pick up free Grab ‘n Go meals for the youth in your households? *This question is required.

• Yes, frequently
• Yes, sometimes
• Rarely
• No, never
• Not Sure

If no, check all that apply: *This question is required.

• There are no sites near me
• I do not have transportation to meal distribution sites
• The sites are not serving meals in the hours that work for me
• Showing proof of children in the household is too difficult
• I am utilizing other benefits instead
• I do not need food assistance right now
• My children do not like the meals
• My children are on a special diet that is not accommodated by the meals distributed at these sites
• The sites are too crowded/COVID concerns
• I have concerns about showing documentation in such settings
• Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

What working appliances do you have for storing/preparing foods? *This question is required.

• Refrigerator
• Microwave
• Toaster/Oven
• Crockpot
• Stove
• None
• Other - Write In (Required)