Double up Food Bucks New York

SHOPPERS

Earn Free Produce with EBT

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PARTNERS

Help Increase Food Access in Your Community

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Where can I use Double Up Food Bucks

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Sept 27-Oct 4

Double Up Food Bucks Awareness Week

Interested in Double Up Food Bucks?
Fill out the form below!

First Name *

Last Name *

E-mail *

Phone *

Zip Code *

Do you have SNAP/EBT? *

Are you interested in signing up for Double Up?

Talk to Us

Thank you for answering a few questions about Double Up. We use the information you provide to help improve Double Up Food Bucks for everyone.

What suggestions for improvement or questions do you have about Double Up Food Bucks?

How did you hear about Double Up? *

Mail to my home
Friend or Family
Community Organization
Healthcare Provider
Email
Social media
Advertisement (such as a billboard or bus)
MDHHS office
In the news
At a participating location (on a flyer or poster)

Please select one reason.

Please enter your zip code. *

This field is required.

Do you have SNAP/food stamps? *

Yes
No, but I think I qualify
No, I don't qualify

Please check one.

How long have you been a Double Up shopper? *

1-6 months
7-12 months
1-2 years
2-5 years
More than 5 years
I'm not currently a Double Up shopper

Please check one.

What is the best way for Double Up to share information in your community? *

Text message
E-mail
Social media
Double Up Food Bucks website
Hotline
Other

Please check all that apply.

What information might be useful on the website that isn’t currently available?

Are you planning to expand your family in the next year? *

How many children are you caring for in your home under the age of 3? *

0
1
2-4
4 or more

Would you be willing to share your story using Double Up Food Bucks with others?

Would you be willing to talk to us directly about how we can better serve you and other shoppers? *

Please provide a phone number or email address for Double Up to share program info with you from time to time.

Email *

Phone *