Food Pantry Client Registration

Food Pantry Client Registration — Form Fields

This nonprofit template includes 10 fields. Register a new household for ongoing food pantry services and track dietary needs. Free to customize and use on ZenBuild.

• Head of Household Name (text, required)
• Email Address (email, optional)
• Phone Number (text, required)
• Home Address (text, required)
• Number of Adults in Household (number, required)
• Number of Children in Household (number, required)
• Visit Frequency Requested (dropdown selection, required) — options: Weekly, Bi-weekly, Monthly
• Dietary Restrictions or Needs (checkboxes, optional) — options: Vegetarian, Halal, Kosher, Gluten-free, Diabetic-friendly, No pork, Nut allergy, Other
• Do you have transportation to pick up food? (multiple choice, required) — options: Yes, No – need delivery
• Additional Needs or Notes (long text, optional)