Meals on Wheels People

Please fill out the entire form and click Submit to apply for the SFMNP EBT card.

Applicant Information

Applicant First Name:

Applicant Last Name:

Phone (xxx-xxx-xxxx):

Email Address:

Date of Birth (MM-DD-YYYY):

Mailing Address Line 1:

Apt / Suite:

City:

State:

Zip Code:

The Senior Farmers Market Nutrition Program (SFMNP) provides fresh fruit and vegetables to lower-income seniors with the goal of improving their health and nutritional status. It also supports local farming by increasing the use of farmers markets and roadside stands.

1. You must be 60 years old or older (or 55+ if you are Native American / Alaska Native)

2. Your income must be below 185% of Federal Poverty Level. That means:
- below $2,248 monthly income for 1 person
- below $3,040 monthly income for 2 people
- For larger households, add $792 for each additional person

Do you meet ALL of the above requirements?
YesNo

Do you consider yourself Hispanic/Latino:
YesNo

By clicking “submit”, I acknowledge the information entered above is true and correct. I agree to enter one affidavit per person. I also acknowledge my submission may be put on a waitlist or denied if deemed a duplicate, invalid information or address, or I do not meet the qualifications listed above.
YES, I AGREE

I understand that if I am unable to pick up the EBT card, I will sign a proxy form and assign an individual to do so for me.

TEST - DO NOT USE

Applicant Information

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Applicant Information

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