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1. Are you a University student? If so, please specify your year in college (Required.)

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2. Indicate your level of agreement to the following statements: 

"I struggle to afford groceries during a typical week."

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3. “I feel like I would benefit from additional support for food costs.” 

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4. “I am aware of what SNAP (Supplemental Nutrition Assistance Program) is”

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5. “I am aware of Mountain Root’s weekly backyard harvest”

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6. During the last two weeks, how frequently did you worry about affording groceries:

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7. Would you like to have someone follow up with you with food support resources? If so, please provide contact information. Email/phone # 

This information will be shared with Mountain Roots and the Food Pantry Staff for assistance/follow up.

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