Order Form pfp December 20, 2020 The Plymouth Community Food Pantry offers this form to help you access the foods you prefer. We will do our best to update the choices available every Wednesday afternoon after receiving our delivery. Simply complete the form and "SUBMIT". You will receive an acknowledgement that your order has been received. We will contact you as soon as possible to set up an appointment for curbside pick-up. If you do not receive an item that you requested, it is because our stock has been depleted. Please enable JavaScript in your browser to complete this form.LAST Name *FIRST Name *Number of People in Household *Phone *Date You Plan to PICK-UP Order *Do you need your order delivered?noyesPlease record your address if you need your order delivered *Address Line 1CityCTAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateEnter any dietary restrictions you may haveVOLUNTEER TAKE NOTICESelect the cereal you would preferCheriosCorn FlakesHoney OatsHoney NutShredded WheatQuaker OatsGolden CrunchFarinaCanned Pasta, select the number of cans you would likeNone1 can2 cansCanned Pork Stew, select the number of cans you would likeNone1 can2 cans3 cansBeef Stew in a pouch, select the number of pouches you would likeNone1 pouch2 pouches3 pouchesBaked Beans, select the number of cans you would likeNone1 can2 cans3 cansChili in a Pouch, select the number of pouches you would likeNone1 pouches2 pouches3 pouchesChicken Boned in a Pouch, select the number of pouches you would likeNone1 pouches2 pouches3 pouches---------------------------------------------CANNED VEGETABLES---------------------------------------Select the number of each can you would like; 1-3 people-up to 3 cans, 4 people or more-up to 7 canscornNone1 cans2 cans3 cans4 cans5 cans6 cans7 canspeasNone1 cans2 cans3 cans4 cans5 cans6 cans7 canssweet potatoesNone1 cans2 cans3 cans4 cans5 cans6 cans7 cansgreen beansNone1 cans2 cans3 cans4 cans5 cans6 cans7 canspotatoesNone1 cans2 cans3 cans4 cans5 cans6 cans7 cansmixed vegetablesNone1 cans2 cans3 cans4 cans5 cans6 cans7 cansAssorted Beans: Select the number of cans you would like (1-3 people-2 cans) (4 and up- 3 cans)None1 can2 cans3 cansCheck the Beans you would preferBlack BeansChick PeasSoups, list the type of soup(s) you would like in the box below (e.g., chicken noodle, broth, ramen noodles, etc.)-------------------------------------------------CANNED FRUIT-------------------------------------------Select the number of each can you would like; 1-3 people-up to 2 cans, 4 people or more-up to 3 canspeachesNone1 cans2 cans3 canspearsNone1 cans2 cans3 cansmixed fruitNone1 cans2 cans3 cansdried prunes/raisinsNone1 cans2 cans3 cansRice (bags/boxes): Select the number of bags/boxes you would like (1-3 people-1 bag/box) (4 and up- up to 2 bags/boxes) None1 bag/box2 bag/boxCheck the rice you would preferwhitebrownprepackaged rice mealCanned Tuna or Chicken; Select the number of cans you would like (1-3 people-2 cans) (4 and up- up to 4 cans)None1 can2 cans3 cans4 cansCheck which you would prefertunachickenEnter the type of condiments you would like in the box below (e.g., salad dressing, mustard, barbecue sauce, etc.)Enter the type of drink(s) you would like in the box below (e.g., water, juice, flavored water, etc.)Select 2 out of the 4 items below or nonePeanutbutterJellyNonePancake MixPancake SyrupTomato Sauce, select the number of cans/jars you would like, (1-3 people-up to 2 cans) (4 and up- up to 4 cans)None1 can/jar2 cans/jars3 cans/jars4 cans/jarsCrushed/Diced Tomato, select the number of cans/jars you would like, (1-3 people-up to 2 cans) (4 and up- up to 4 cans)None1 can/jar2 cans/jars3 cans/jars4 cans/jarsEnter the type of personal item(s) you would like in the box below (e.g., deodorant, tooth paste, soap etc.)Select the items you would likeToilet PaperPaper TowelsLaundry DetergentDog FoodCat FoodCoffeeTeaHot CocoaBoxed PotatoesGravyStuffingCranberry SauceIndividual Snacks CrackersCookiesChipsCake MixBaking SuppliesPastaSpaghettiMac & CheeseDried LentilsBoxed MilkSelect the produce you would likePotatoesCarrotsOnionsLettuceApplesButternut Squash HalvesTomatoesEggplantGrapes------------------------------------------------Meat/Poultry/Fish-------------------------------------------------------------------------------(1-3 people-up to 3) (4 people or more - up to 5)---------------------------------------------------------------------Select by choice-----------------------------------------Chicken CutletNone1st choice2nd choice3rd choice4th choice5th choiceWhole ChickenNone1st choice2nd choice3rd choice4th choice5th choiceChicken DrumsticksNone1st choice2nd choice3rd choice4th choice5th choiceChicken QuartersNone1st choice2nd choice3rd choice4th choice5th choiceChicken Breast BonelessNone1st choice2nd choice3rd choice4th choice5th choiceGround TurkeyNone1st choice2nd choice3rd choice4th choice5th choiceHamburger/beef/veal/porkNone1st choice2nd choice3rd choice4th choice5th choiceShrimp, 2 lb. BagNone1st choice2nd choice3rd choice4th choice5th choiceTurkey (12-14 lbs.) None1st choice2nd choice3rd choice4th choice5th choiceSelect the dairy/frozen items you would likeMilkFresh EggsFrozen EggsFrozen Green BeansFrozen Fruit CupFrozen Mac & CheeseFrozen Blueberries, 2.5 lb. BagOatgurt, Strawberry/BlueberryLightly Salted ButterCheck the appropriate box if you need diapers for a member of the household.Baby DiapersAdult DiapersEnter the diaper size for the baby *Enter the diaper size for the adult *Are there any item(s) that were not listed and you might want.YesNoEnter any item(s) that were not listed and you might want.CommentsSubmit Share this post Share
