This form's purpose is to allow current pantry clients to designate an individual to pick up their monthly pantry distribution on their behalf. The proxy will be required to show I.D. to confirm for our records.

The easiest route is to print off and have the proxy bring the form with them to pick up your distribution, please download the following form and sign ahead of your distribution date:

Proxy Form

OR 

Fill out the form to the right and a staff member from GWCFB will call to confirm the proxy request prior to your distribution date.

© GWCFB

Call us:

724-632-2190

Find us: 

909 National Pike West, Brownsville, PA 15417