Bridgecare Pantry Application Form

Applicant's Information

First Name: *

Last Name: *

Date of Birth *

Mobile Number *

Email Address: *

Home Address *

Living Conditions: *

Property Owner

Renting

Other

Household Income

Monthly Income, including pension: *

Are you receiving support from any other services currently? *

Yes

Other Information

How did you find out about us?

Household Information

How many adults are in your household? *

How many children are in your household? *

Are there any dietary requirements?

Document Checklist

Please select which form of identification you will bring with you to collect your food parcel.

Identity Document *

Photo Identity Card

Centrelink Card

Healthcare Card

Anything else we should know?

Terms and Conditions

1. Upon a successful application, Bridgecare will provide food relief through the Bridgecare Pantry Program, distributing up to 10 food parcels per year.

2. Successful applicants are entitled to collect 1 food parcel on a Wednesday from 11pm-2pm at the Bridgecare Pantry located at 294 Graham Rd, Bridgeman Downs, 4035.

3. Each food parcel is provided free of charge and typically includes a mix of perishable and non-perishable food items donated to Bridgecare from various organisations. Bridgecare reserves the right to change the contents of the food parcels when required.

4. Eligibility for this program is based on the specific catchment area that Bridgecare is able to support.

Applicant's Declaration

By submitting this form, I confirm that the information provided is true and accurate. I understand that any personal information collected through this form is intended for the Bridgecare Pantry and will be kept confidential. I also acknowledge that submitting this application does not automatically grant me eligibility to receive a free food parcel.

Applicant Signature *

Date *

Privacy Policy

We take your right to privacy very seriously and treat all of the information you give us confidentially and in accordance with Australian Privacy Principles

By selecting "submit" you are confirming that you have read and agree to the Bridgeman Baptist Community Church Privacy Policy.

I have read and agree to the Privacy Policy.

- BRIDGEMAN BAPTIST COMMUNITY CHURCH -
www.bridgeman.org.au