SNAP Sign up – Feed & Seed Co.

Name *

First

Last

Email *

Phone (best # for pickup reminders) *

Preferred Communication Method: (Pickup/Order Reminders) *

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Full name EXACTLY as shown on your SNAP/EBT card. *

Do you have a South Carolina SNAP card? (Select one answer)

YES, I have a South Carolina SNAP card
NO, my card was issued in another state

Pick-Up Site *

How many boxes would you like? (Paid for & picked up every other week.) *

If paying with SNAP/EBT, only 1 box can be purchased for your first and second pickups, then 2 boxes beginning third pickup. Please read FAQ on previous page for information regarding box quantity limitations.

How did you hear about Foodshare?

Additional information for the FoodShare team (optional)

Order Agreement (CHECK BOX TO AGREE) *

I understand that by submitting my order I am committed to pick up the ordered produce box at the next available distribution. I also understand that I must bring my SNAP/EBT card for payment to receive the cost of $5 per box, otherwise I must have $20 cash or card to pay full price for the box.

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