Choice Food Pantry Food Choices

Food Choice

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* Please provide the following information

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* Are you interested in any of the following adult education classes? Please select all that apply.

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* Which school district do you live in?

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* Please tell us total number of  people in your household that are registered with our agency?

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* How many seniors, How many adults, How many children?

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* Please choose meats.  Up to 3 choices for families.

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* Please choose 2 freezer item

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* Please choose your dairy items.  One type of cheese per client.

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* Please choose 2 types of canned soups

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* Please choose up to 6 dry items

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* Please choose 2-3 types of canned vegetables

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* Please choose 1-2 canned meats

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* Please choose up to 4 miscellaneous items

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* Please choose one type of cereal

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* Please choose 1 drink plus type of coffee

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* Please choose 2  snacks

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* Please choose 2 types of canned fruits

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* Do you or anyone in your household have any special dietary needs?
If so, please explain

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* Would you like to get free diapers, wipes, baby food, and other baby items once a month? If so, you must register for our baby club. You must submit a copy of the child's birth certificate or guardianship paperwork to participate. It is very easy. Baby Club members, please list diaper, pull up and clothing sizes, formula type, food stages in box below.

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* Are there any items that you do not want to receive from us?
Do you need any of the following:
Depends - list size




 List size depends if needed.

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* Please do not forget to schedule your pantry food pick up using the link on our website after you hit "CLICK HERE IF FINISHED" below.

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* PLEASE NOTE***
All selected food items are based on availability.

Our building and pantry are exposed to nuts through various food products that we carry.

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* Do you or anyone in your household have a birthday this month? If so, please enter their name and date of birth in the text box below.

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* Do you feel safe at home?

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* If you are a victim of abuse please call the YCWA hotline at 1-800-262-8444.

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