Food Pantry Delivery

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* 1. Do you need assistance from the Huston Academy Food Pantry?

Yes

No

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* 2. If you answered “No” to Question 1: Thank you for participating in our survey.

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* 3. If you answered “Yes” to Question 1: What delivery method would you prefer?

Pick Up at Huston Academy

Delivery to your home or business

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* 4. Student Name

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* 5. Delivery Address

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* 6. Best Contact Phone Number