COMMUNITY REACH INC FOOD PANTRY FOOD CHOICES

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* 1. PLEASE PROVIDE THE FOLLOWING INFORMATION

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* 2. WHICH SCHOOL DISTRICT DO YOU RESIDE IN?

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* 3. HOW MANY PEOPLE RESIDE IN YOUR HOUSEHOLD? If you hace 5 or more continue with this form. If 1-4 , please complete the other food pantry choice form.

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* 4. PLEASE TELL US HOW MANY HOUSEHOLD MEMBERS ARE IN EACH AGE GROUP BELOW

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* 5. FREEZER CHOICE - CHOOSE 1

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* 6. PLEASE CHOOSE 3 TYPES OF CANNED VEGETABLES

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* 7. PLEASE CHOOSE UP TO 3 CANNED FRUIT

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* 8. PLEASE CHOOSE 2 CAN of MEAT

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* 9. PLEASE CHOOSE UP TO 3 DIFFERENT CANS OF SOUP

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* 10. PLEASE CHOOSE UP TO 10 DRY GOODS

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* 11. PLEASE CHOOSE 1 DRINK

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* 12. PLEASE CHOOSE UP TO 12 CHOICES

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* 13. PLEASE CHOOSE YOUR DAIRY OPTIONS

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* 14. PLEASE CHOOSE 2 MEATS

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* 15. DO YOU OR ANYONE IN YOUR HOUSEHOLD HAVE ANY ALLERGIES? IF SO, PLEASE PROVIDE DETAILS

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* 16. DUE TO THE HIGH VOLUME OF CLIENTS WE ARE NOW SERVICING, WE MAY NOT BE ABLE TO ANSWER THE PHONE OR RETURN CALLS UNTIL THE NEXT BUSINESS DAY. IF YOU HAVE QUESTIONS OR CONCERNS PLEASE SEND AN EMAIL TO OFFICE@COMMREACH.ORG

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* 17. DO YOU HAVE A BABY CLUB PICKUP WITH THIS ORDER? 
IF YOU WOULD LIKE TO REGISTER FOR OUR BABY CLUB PLEASE VISIT OUR WEBSITE. YOU MUST SUBMIT A BIRTH CERTIFICATE OR GUARDIANSHIP DOCUMENTS PRIOR TO YOUR FIRST BABY CLUB PICKUP.
EACH AND EVERY MONTH YOU MUST SUBMIT THE BABY CLUB REQUEST FORM ON OUR WEBSITE.

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* 18. DOES ANYONE 12 AND UNDER IN YOUR HOUSEHOLD HAVE A BIRTHDAY THIS MONTH? IF SO, PLEASE LIST THEIR NAME AND DOB.  THIS IS FOR CHILDREN ONLY!

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* 19. Do you have any school aged children, ages 5-17, as a registered member of your household? If yes, we will include an extra bag of easy to prepare meals and snacks during the summer months of June, July and August. You will receive with your regular monthly pantry pick up appointment.

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