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Pinellas CARES Food Request

Please be aware that your information will be shared with RCS Pinellas.

*1
*2
Phone Number:
*3
Email Address:
*4
Zip Code
*5
Household Number
*6
Household Income
7
Please select your age (optional)
*8
Campus Pickup Location/Time
*9
Please select from the items below all of the areas in which you/your household has been affected by COVID:
10
Please list loss of basic needs:
 

If you have any questions or comments about this survey, please contact Melissa Holtz at Holtz.Melissa@SPCollege.edu or call (727) 341-3176

St. Petersburg College is committed to equal access/equal opportunity in its programs, activities, and employment. For additional information visit www.spcollege.edu/eaeo/. St. Petersburg College is an Equal Opportunity Employer.