Request for Services Form
Please complete and submit this form to be considered for assistance through the St. Nicholas Mobile Pantry: Charity on Wheels Program. Someone from Catholic Charities will follow up with you via email or phone to confirm date, time and location of distribution. An email and phone number are required.
If you are unable to submit this request online, please use this link to download a form to print and mail. Requests should be mailed to:
St. Nicholas Mobile Pantry
419 NE Madison Avenue
Peoria, IL 61603
Requests will be reviewed at noon on each Friday. Any request made after that time will be considered for the following delivery period.