MFP New Client Intake

Thank you for your interest in becoming a Mitzvah Food Program client.

Please submit your application only once. We want to assure you that we’ve received it and are doing our best to serve everyone as quickly as possible during this challenging time. If you have any questions please email us at the email provided below.

If you need to fill this form out in another language, please select from the list in the upper right hand corner above this text. 

We are here to provide you and your family with fresh, frozen and nonperishable food with kosher options.  

In order to begin the process of becoming a client, we ask that you fill out the following form. If you have any questions, contact mitzvahfoodprogram@jewishphilly.org or 215.832.0509.

Please know that this form is not mandatory to receive food in person. This information is confidential and will not affect your eligibility for food. Every question must be answered clearly (N/A, none, or 0 if your answer does not apply). Our four pantries distribute nutritious food to all who are in need, regardless of race, income, gender, age, or religion. Additionally, this information is only required in order to become a full client of our pantry, not to receive emergency food.

Due to the high demand for our services, we may need to place your name on a waitlist. We are working diligently to provide food service to your family as quickly as possible and appreciate your understanding as we manage this increased need. In the interim, please find a link to additional community resources here:

Please provide an email or phone number so we can reach you about pantry services.

I, (hereinafter the “Undersigned”) wish to receive services from a Volunteer and/or Agent through the Mitzvah Food Program (hereinafter referred to as “MFP”) service. The Undersigned understands that the Volunteer and/or Agent will perform certain activities related to serving as a volunteer and/or agent (“the Activities”).

Scope of Volunteer Position: The Undersigned understands that the scope of the Volunteer’s relationship with MFP is limited to a volunteer position; that the Volunteer is not an employee of MFP and no compensation is expected in return for services rendered; that MFP will not provide any benefits to the Undersigned beyond connecting the Undersigned and the Volunteer; and that the Undersigned is responsible for his/her/their own insurance coverage in the event of personal injury or illness arising out of the Activities.

Scope of MFP’s Role: The Undersigned expressly acknowledges that MFP is acting solely as an intermediary between beneficiaries in need of services and volunteers and/or agents willing to provide such services; that MFP’s involvement ceases once a volunteer and/or agent is connected with a beneficiary; and that MFP exercises no control over the receipt of services or any other agreement between the Undersigned and the Volunteer and/or Agent.

Release, Waiver and Indemnification: The Undersigned hereby releases, waives, discharges and covenants not to sue MFP and/or its insurers, its attorneys, its insurer’s attorneys, or anyone for whom MFP or its insurer may be legally liable (herein the “Releases”) for liability to the Undersigned, his/her/their personal representatives, employers, insurers, assigns, heirs, and next of kin due to any and all loss or damage, and any claim or demands therefore on account of injury to Undersigned’s person or property or resulting in death of Undersigned, whether caused by the negligence of the Releasees, or Volunteer, or Agent, or otherwise while Volunteer and/or Agent is on or around the Premises or in any way arising out of the Activities.

The Undersigned further hereby assumes full responsibility for and risk of bodily injury, death or property damage due to the negligence of Releases, or Volunteer, or Agent, or otherwise while on or around the Premises or in any way arising out of the Activities. The Undersigned further agrees to defend and indemnify and hold Releasees harmless from and against any and all loss, damages, injuries, liability, claims, suits, costs and expenses whatsoever, including reasonable attorneys' fees, regardless of the merit or outcome of any such claim or suit arising from or in any manner connected to the Activities.

The Undersigned further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of Pennsylvania and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

The Undersigned has read and voluntarily signs this release, indemnity and waiver of liability agreement and further agrees that no oral representations, statements, or inducements apart from the foregoing written agreement have been made.