Meal delivery intake form
Please fill out this form to give us information needed to start your meal box deliveries! Please fill out only once per household. PLEASE ONLY FILL OUT THE FORM AFTER FOODCHAIN INVITES YOU TO DO SO AND IF YOU LIVE WITHIN THE LEXINGTON-FAYETTE COUNTY AREA. Deliveries are currently scheduled to each household once per week, Tuesday-Friday, during the day. After we receive your responses, we will contact you to confirm a delivery window and a delivery start date. 
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Name, first and last of recipient *
Date of Birth of Primary Recipient *
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FoodChain Offers this free meal delivery program to anyone who is experiencing food insecurity.  We define food insecurity as having difficulty affording, accessing, or getting transportation to enough nutritious food.  *
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