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Request for Help
We all need a little extra help from time to time. There is no shame or embarrassment in requesting some help. Be assured your request will be handled confidentially.
Papamoa Food Hub delivers on Thursdays to permanent Papamoa residents only.
Please Note: Our primary purpose is to support Papamoa FAMILIES in desperate need of
short term food support.
If you are outside of the 3118 postcode please do not apply as you are ineligible for assistance.
I need some extra help with:
Food Parcel - 5 days
Pantry Top Up Parcel
Financial - Budgeting/Mentoring
In order for us to prepare and deliver appropriate parcels, please complete the following details honestly.
Applicants name
*
First name
Last name
Applicants Cell phone
*
Applicants Email address
*
We need to know where you live so we can deliver your parcel.
Household Address
*
Address line 1
Address line 2
Address line 3
Address line 4
Town/Suburb
City
Postcode/Zip
Our deliveries are made on Thursdays from 10.00am to 1.00pm
Applications for next day delivery close at 4pm Wednesdays.
Applicant must be present to receive the delivery and may be asked for photo ID to confirm identity.
You may also be asked to supply additional documents.
I agree that I will be at home to receive the delivery between 10am and 1pm, And have my PHOTO I.D with me.
*
Additional information needed so we can prepare the most appropriate parcel for you, and for our required reporting.
Known Allergies
*
Please ensure that you check all food packaging yourself before consuming any food or using any products provided by Papamoa Food Hub to ensure that products are suitable for use and/or consumption. Papamoa Food Hub does not accept any liability for any adverse reactions experienced.
Your Date of Birth
*
Gender Identity
*
Female
Male
Other
Ethnicity
*
NZ Euro
Maori
European
Pacifica
Asian
Other
Employment
*
Accident Compensation (ACC)
Self Employed
Full time
Part time
Student
Not employed
Other
Residence
*
Freehold
Mortgaged
Rental
Govt.
Social
Emergency
Other
How many people do we need to provide for?
Total Number in people in household
*
How many people will the parcel need to provide for?
Please click below and enter all members of this household that we will be providing for
in order to provide age and gender appropriate items. ie toiletries
Click Here
Persons name
*
First name
Last name
Date of Birth
*
Gender Identity
Female
Male
Other
Relation to Applicant
*
Adult
Applicant
Child
Partner
Allergies
*
Partner Employment
*
Accident Compensation (ACC)
Self Employed
Full time
Part time
Student
Not employed
Other
Single line text
+ Add further dependants /members of household
- Remove
Tell us a little about yourself and your situation, and what brings you to PFH for food support.
*
How did you hear about Papamoa Food Hub?
*
So we know if you can prepare the meals we will be providing please let us know what facilities you have available.
Kitchen/Cooking Facilities
*
Air Fryer
Cooktop
Crock Pot
Freezer
Fridge
Microwave
Oven
In order to keep our volunteers safe when delivering your parcel please tell us
Is there a dog at the property?
*
No
Yes
Is there any illness such as flu, coughs COVID or any other gastro or contagious illnesses.
*
Have you applied for Or received any food support from ANY agencies in the past 12 months?
*
No
Yes
If Yes please specify from where and when
As a PFH recipient do you authorise PFH to share information with other food support agencies? If you answer NO, you will be asked to explain why.
*
No
Yes
I would like to receive the Papamoa Food Hub Newsletter
Thank you, one of our team will be in touch soon to discuss how we can best deliver your request. You may be asked for additional documentation to support your application.
Submit
Please check the highlighted fields
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