Request Form for Emergency Food Pantry Assistance 


Please complete in its entirety and submit. 

PLEASE NOTE:  If the required questions are not answered, you cannot proceed to the next page

If you have difficulty completing this request form please call the crisis line at: 704-225-0440


Bridging the Gap Between Crisis and Hope since 1985

The mission of Union County Crisis Assistance Ministry’s Crisis Intervention Program is to provide a bridge from crisis to stability for individuals in our community who are at risk of losing their most basic needs of shelter and food during personal or family crisis.