Recipient Application

Apply for Meals!

If you are interested in applying to recieve Meals on Wheels for yourself or a loved one, please continue to the form below. As a reminder, those who qualify for our program are:
  • Ages 60 and above.
  • Cannot prepare meals for themselves and do not have someone who can prepare meals for them.
  • Are homebound, no longer drive themselves, and/or rely on others for transportation needs.
Click here to find more information about our eligibility requirements. Please note that there must be an assessment performed to start service, and that there may be a delay between form submission and assessment date. 
Recipient Information:
Contact Information
Are you homebound?
Our homebound definition - one or more could apply to you:
  • Not driving
  • Driving very little only in emergency
  • Only drive to get to doctor appointment
  • Would drive less if I had home delivered meals
  • Only drive in necessity and would be safter if I didn't drive
Emergency Contact Information

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