Bread of Life Food Pantry

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pilot Mountain Baptist Association

PMBA BREAD OF LIFE FOOD PANTRY

Located at Forest Hill Baptist Church

402 E. Polo Road, Winston-Salem, NC 27105

Open Every Thursday from 1 PM – 7 PM

REFERRAL

Date:_______________

Name:___________________________________________________________________________________________

Address:_________________________________________________________________________________________

The above listed person/family is being referred by _______________________________________________

Church/Agency

_____________________________________________ to the PMBA Bread of Life Food Pantry for assistance with

hunger issues.  I have explained that they need to provide proof of residence and nature of hardship.

____________________________________________________________

Name (Please Print) of Minister/Director

____________________________________________________________

Signature of Minister/Director