Write-Right Nutrition Program Application

Families With Children & Youth

About one in five households with children in the United States face food insecurity at some point during the year. More than half a million children in Georgia don’t have consistent access to enough nutritious food. This can have long-term effects on their health and future.

Kids who are food insecure are more likely to be held back a grade in elementary school, more likely to be sick and hospitalized, and more likely to have growth and developmental issues. The Write-Right Nutrition Program (WRNP) is a hunger relief program designed to assist families with children and youth who experience food insecurity. Primary caretakers and/or legal guardians of children and/or youth under the age of 17 years may complete this application. In addition, our hunger relief program provides nutritional literacy information on healthy foods to eat and tips on creative ways to prepare healthy meals on a budget.

Date:

Full Legal Name(required)

Email(Optional)

Phone(required)

Ethnicity(required)

Date of Birth(required)

Are you a U.S. Citizen? Must be a USA citizen to apply.(required)

Yes No

*Asylum seekers and/or refugees who have left their country and is seeking protection from persecution and serious human rights violations will be considered on a case-by-case basis.

Are you an asylum seeker or refugee?(required)

Yes No

Home Address/Current Residence(required)

City(required)

State(required)

Zip Code(required)

If you answered yes to the above question, please list the children’s age and gender below:

How did you hear about the Write-Right Nutrition Program?(required)

Please note the Write-Right Nutrition Program is a charity program. All nutrition events and grocery giveaways will be contingent on available grant funding. Approved program applicants will be provided 1 bag of food per month. Program participants will need to complete a new application annually.

A valid state issued identification card must be presented during food pick-up

* Asylum seekers and/or refugees will temporarily be exempt from providing A valid state-issued identification card.

* Nutrition events are free events in which WRNP and WRLP program participants will be provided free lunch/dinner and food nutrition information.

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Your privacy is critically important to us, and we secure your privacy by adhering to the following:
We only ask you to provide personal information as it relates to onboarding new members of the board of directors, enrolling qualifying applicants in our charity programs, and when hiring contractors.
We store personal information only as long as we have a reason to keep it.
We share your personal information with Federal, State, and local governmental agencies for reporting purposes. Inaddition, as part of their oversight role and fiduciary duties, existing members of the board of directors may review anypersonal information we collect.
All personal information is stored in our internal, secure company database. Only trusted, high-level senior staff andmembers of the DFOWW Incorporated board of directors can access such privileged and sensitive information.
We aim for full transparency on how we gather, use, and share your personal information.

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