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Home
About Us
Annual Report
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Board Materials
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Vision, Mission and Culture
Financial Info
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Staff Directory
ALICE
ALICE
Helping ALICE
Making Tough Choices
ALICE 2020 Webinar
Join Us
Donate
Essential Goods for Basic Needs Donors
Advocate
Contact Us
In the Workplace
Volunteer
Our Work
United Way’s 211 Helpline
Financial Stability
ALICE $ense Sign-Up
Financial Stability
Ride United Last Mile Delivery Program Resources
Dasher Resources
Partner Resources
Feeding United Delivery Program Resources
ESSENTIAL GOODS FOR BASIC NEEDS – How To Get Stuff for Your Nonprofit
Essential Goods for Basic Needs Donors
Nonprofit Support
Emergency Food and Shelter Program
Capacity Building
Health
Westchester COAD
Food and Nutrition Resources
Nutrition Assistance
Nutrition Tips
Veggie Spotlights
Cooking Tips
Budgeting Tips
Printable Handouts
Education
Education United
United2Read
Featured
White Plains Hospital Food Delivery Program
White Plains Hospital Food Delivery Program
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What is your address? ¿Cual es tu dirección?
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Please input your CELLPHONE number to receive important delivery notifications. If you do not have a cellphone number you can input your home number. /Ingrese su número de TELÉFONO CELULAR para recibir notificaciones de entrega importantes. Si no tiene un número de teléfono celular, puede ingresar el número de su casa.
Email Address / Dirección de correo electrónico
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Are you a Veteran? / ¿Es usted veterano?
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Yes
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Please select the language this client prefers to communicate in/seleccione el idioma en el que prefiere comunicarse:
*
English
Spanish
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Financial Qualifier (No documentation is needed to prove the below scenarios)
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Categorical Eligibility: You are categorically eligible to receive USDA Foods through TEFAP if your household participates in any of the following programs: SNAP, WIC, TANF, Medicaid, or SSI.
Household Income: If your gross annual household income is at or below the amount listed for the number of people in your household, you are eligible to receive USDA Foods through TEFAP.
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Elegibilidad categórica ( No se necesita ningún tipo de documentación para demostrar las situaciones mencionadas arriba.)
*
Usted es categóricamente elegible para recibir alimentos del USDA a través del TEFAP si su hogar participa en cualquiera de los siguientes programas: SNAP, WIC, TANF, Medicaid o SSI.
Ingresos del hogar: Si los ingresos brutos anuales del hogar son iguales o menores a la cantidad indicada para el número de personas en su hogar, usted es elegible para recibir alimentos del USDA a través del TEFAP.
Number of People in Household / Número de personas en el hogar
*
How many children ages 0-4, are in your household? ¿Cuántos niños de 0 a 4 años hay en su hogar?
*
This program requires households to have at least one school-aged child. Este programa requiere que los hogares tengan al menos un niño en edad escolar.
How many school-aged children (ages 5-8) are in your household? ¿Cuántos niños en edad escolar (entre 5 y 8 años) hay en su hogar?
*
This program requires households to have at least one school-aged child. Este programa requiere que los hogares tengan al menos un niño en edad escolar.
How many school-aged children (ages 9-11 ) are in your household? ¿Cuántos niños en edad escolar (entre 9 y 11 años) hay en su hogar?
*
This program requires households to have at least one school-aged child. Este programa requiere que los hogares tengan al menos un niño en edad escolar.
How many school-aged children (ages 12-17 ) are in your household? ¿Cuántos niños en edad escolar (entre 12 y 17 años) hay en su hogar?
*
This program requires households to have at least one school-aged child. Este programa requiere que los hogares tengan al menos un niño en edad escolar.
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Please list the age of each child in your household. Indique la edad de cada uno de los niños de su hogar.
*
How many adults (ages 18-59) are in the household? ¿Cuántos adultos (entre 18 y 59 años) hay en el hogar?
*
How many seniors (ages 60+) are in the household? ¿Cuántos adultos mayores (mayores de 60 años) hay en el hogar?
*
Delivery instructions / Instrucciones de entrega
*
Please share any information that would be helpful to DoorDash drivers. / Comparta cualquier información que pueda ser útil para los conductores de DoorDash.
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Al marcar esta casilla, usted declara que lo siguiente es verdadero:
*
1. El nombre, la dirección (*en la medida de lo posible) y la cantidad de miembros del hogar del beneficiario que se indican arriba son correctos. 2. El beneficiario vive en el estado de Nueva York (no se requiere un período mínimo de residencia). 3. El beneficiario cumple con la opción 1 o la opción 2 de las directrices de elegibilidad del TEFAP antes indicadas. 4. Estos alimentos son solamente para consumo en el hogar del beneficiario, y no se venderán, comercializarán ni intercambiarán. 5. El beneficiario está enterado de sus derechos civiles, que se describen en la "Declaración de no discriminación" del USDA más adelante.
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By checking here, you attest that the following is true:
*
1. The recipient’s name, address (*to the extent practicable) and household size provided above is correct. 2. The recipient resides within New York State (there is no minimum length of residency required). 3. The recipient meets Option 1 or Option 2 of TEFAP eligibility guidelines above. 4. This food is for the recipient’s home consumption only, and will not be sold, traded or bartered. 5. The recipient is aware of their civil rights as described in the USDA Nondiscrimination Statement below.
Declaración de no discriminación del USDA Para todos los demás programas de asistencia de nutrición del FNS, agencias estatales o locales y sus subreceptores, deben publicar la siguiente Declaración de No Discriminación: De acuerdo con la ley federal de derechos civiles y las normas y políticas de derechos civiles del Departamento de Agricultura de los Estados Unidos (USDA), esta entidad está prohibida de discriminar por motivos de raza, color, origen nacional, sexo (incluyendo identidad de género y orientación sexual), discapacidad, edad, o represalia o retorsión por actividades previas de derechos civiles. La información sobre el programa puede estar disponible en otros idiomas que no sean el inglés. Las personas con discapacidades que requieren medios alternos de comunicación para obtener la información del programa (por ejemplo, Braille, letra grande, cinta de audio, lenguaje de señas americano (ASL), etc.) deben comunicarse con la agencia local o estatal responsable de administrar el programa o con el Centro TARGET del USDA al (202) 720-2600 (voz y TTY) o comuníquese con el USDA a través del Servicio Federal de Retransmisión al (800) 877-8339. Para presentar una queja por discriminación en el programa, el reclamante debe llenar un formulario AD-3027, formulario de queja por discriminación en el programa del USDA, el cual puede obtenerse en línea en: https://www.usda.gov/sites/default/files/documents/USDAProgramComplaintForm-Spanish-Section508Compliant.pdf, de cualquier oficina de USDA, llamando al (866) 632-9992, o escribiendo una carta dirigida a USDA. La carta debe contener el nombre del demandante, la dirección, el número de teléfono y una descripción escrita de la acción discriminatoria alegada con suficiente detalle para informar al Subsecretario de Derechos Civiles (ASCR) sobre la naturaleza y fecha de una presunta violación de derechos civiles. El formulario AD-3027 completado o la carta debe presentarse a USDA por: 1. correo: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; o 2. fax: (833) 256-1665 o (202) 690-7442; o 3. correo electrónico: program.intake@usda.gov Esta institución es un proveedor que ofrece igualdad de oportunidades.
USDA Nondiscrimination Statement In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity. Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by: 1. mail: U.S. Department of Agriculture\Office of the Assistant Secretary for Civil Rights\1400 Independence Avenue, SW Washington, D.C. 20250-9410; or 2. fax: (833) 256-1665 or (202) 690-7442; or 3. email: program.intake@usda.gov This institution is an equal opportunity provider.
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