Goods Distribution Recipient Form

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Register to be a recipient and receive notifications for our various free goods distribution events

Throughout the year Trickster Cultural Center has resources for our community such as care packages, hot meals, and PPE. If you would like to be a recipient, please sign up to receive a notification of when these free goods are available.

For more info or questions, please email Gina at GinaR@TricksterCulturalCenter.org

Email Address*

First Name*

Last Name*

Address, line 1

Address, line 2

City

State

Zip Code

Cell Phone

Veteran? Y or N

Yes No

I am Homebound or a Senior requesting Local Delivery.

Yes No

Number of household members including yourself:

Tribal Affiliation:

Number of household members 60+:

Number of household members school age (K through HS):

Sign me up!

Address Line 1 | City, State | Contact Email | Cell Phone

You request has been submitted!