1. Residency: You must be a resident of Moose Jaw or surrounding service area.
2. Severe Mobility Limitations: You must be unable to physically access the Harvest Pantry due to severe mobility issues.
3. Lack of Support: You must not have family, friends, or caregivers who can assist you in accessing our services.
4. Professional Verification: You must provide a signed letter from a licensed healthcare professional (doctor, nurse practitioner, or other regulated health professional) on official letterhead confirming:
   • Your diagnosis or severe mobility issue.
   • That your condition prevents you from attending the pantry in person.
   • That you lack adequate personal support to access services.
5. Annual Renewal: Eligibility must be renewed annually with updated documentation.

Instructions for Clients

1. Print and fill out the Client Section of this form.
2. Bring this form to your healthcare provider for completion.
3. Ensure the provider attaches their signed statement on official letterhead.
4. Return the completed application and supporting letter to the Moose Jaw & District Food Bank office for review.

After Your Eligibility is Approved

Once your application has been approved, you will be able to access delivery services in one of two ways:

1. Shop Online: Use the login credentials provided by the Food Bank to place your delivery order through our online system.
2. Assisted Booking: If you are unable to use the online system, let us know. During the delivery period, our team will call you directly to confirm the items for your box.