Lodi Food Pantry

Monthly Order Form

Please note, only one order can be placed per household per month.

We will contact you when your order is ready for pickup; please plan for it to take at least 1 week to pull and pack your order. If you need food in the meantime...

Any time you are low on food, you can come up and get pre-packaged meal kits on Mondays & Wednesdays from 11am-2pm. Fresh fruits and veggies are available every week too!

Prefer a Paper Form?

Click here for a printable Order Form

Open PDF Order Form to Print

Pantry - Monthly Order Form
  • Household Info
  • Select Items
  • Review

Household Info & Eligibility

This table shows yearly gross income for each family size. If your household income is at or below the income listed for the number of people in your household, you are eligible to receive food.

As a part of the Ohio JFS regulations, at your first pantry pickup you will need to bring your photo ID and proof of residency. You will also need to sign the JFS Form agreeing that you meet the income guidelines.

Household Size Yearly Income Monthly Income Weekly Income
1 $28,727 $2,394 $552
2 $38,893 $3,242 $748
3 $49,059 $4,089 $943
4 $59,225 $4,936 $1,139
5 $69,391 $5,783 $1,334
6 $79,557 $6,630 $1,530
7 $89,723 $7,477 $1,725
8 $99,889 $8,325 $1,921
9 $110,055 $9,173 $2,116
For each additional household member add $10,166 $848 $196
First & Last
Address
Address
City
State/Province
Zip/Postal
Family Size *
Number of residents in household

Please remember to bring a photo ID and proof of residency with you to every visit.

If this is your first time using the LFC Pantry, you will need to complete the ODJFS Eligibility form.  To minimize in-person contact and to speed up your pickup, you can fill out the form online here , then print, sign, and bring with you at the time of pickup.

If someone will be coming on your behalf, you will need to complete a "Letter of Proxy" form as well, and they will need to bring a copy of your photo ID.