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.Name *FirstLastNumber of People in Household *Phone *Date You Plan to PICK-UP Order or Receive Delivery *Do you need your order delivered? *noyesPlease record your address if you need your order delivered *Address Line 1City?????AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateEnter any dietary restrictions you may haveVOLUNTEER TAKE NOTICESelect the produce you would likePotatoesTomatoesOnionsCarrotsLettuceOrangesCabbageNoneCanned Pasta, select the number of cans you would likeNone1 can2 cansCanned Pork , select the number of cans you would likeNone1 can2 cans3 cansCanned Beef , select the number of cans you would likeNone1 can2 cans3 cansBeef Stew, Pouch , select the number of cans you would likeNone1 can2 cans3 cansBaked Beans, select the number of cans you would likeNone1 can2 cans3 cansSelect the cereal you would preferHealthyChildren Cereal, SweetRice KrispiesOatsInstant OatsNoneWe have many brands of cereal. If you have a favorite, list it and we will try to accomodate your preference.---------------------------------------------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 canspeasNone1 cans2 cans3 cans4 cans5 cans6 cans7 cansgreen beansNone1 cans2 cans3 cans4 cans5 cans6 cans7 canscornNone1 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 BeansKidney BeansGarbanzo BeansSoups, 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 cansFruit CocktailNone1 cans2 cans3 cansPearsNone1 cans2 cans3 cansFigsNone1 bag2 bags3 bagsDried PlumsNone1 bag2 bags3 bagsWould you like White Rice?YesNoWould you like Brown Rice? YesNoSelect the number of Canned Tuna you would like (1-3 people-2 cans) (4 and up- up to 4 cans)None1 can2 cans3 cans4 cansEnter the type of condiments you would like in the box below (e.g., salad dressing, mustard, barbecue sauce, etc.)Select the items you would likeDried LentilsPinto BeansWhole Green PeasBlack BeansBoxed PotatoesStuffing MixYellow Spit PeaPastaSpaghetti, whole wheatMac & CheeseNoneSelect 2 out of the 4 items below or nonePeanutbutterGrape JellyStrawberry JellyPancake MixPancake SyrupNoneTomato 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 PaperLaundry DetergentDog FoodCat FoodBoxed MilkFruit & Nut Mix, 1 lb. bagChipsTeaEnsure (for health reasons)Glucerna (to manage blood sugar)NoneEnter the type of drink(s) you would like in the box below (e.g., water, juice, flavored water, ice tea etc.)Enter the type of bread and pastry you would like.------------------------------------------------Meat/Poultry/Fish-------------------------------------------------------------------------------(1-3 people-up to 3) (4 people or more - up to 5)---------------------------------------------------------------------Select by choice-----------------------------------------Pork ChopsNone1st choice2nd choice3rd choice4th choice5th choiceLambNone1st choice2nd choice3rd choice4th choice5th choiceVealNone1st choice2nd choice3rd choice4th choice5th choiceGround TurkeyNone1st choice2nd choice3rd choice4th choice5th choiceBeef None1st choice2nd choice3rd choice4th choice5th choiceSteakNone1st choice2nd choice3rd choice4th choice5th choicePork Loins 4-5 lbs.None1st choice2nd choice3rd choice4th choice5th choiceChicken, Drumsticks 3lb.None1st choice2nd choice3rd choice4th choice5th choiceWhiting Filet(2 lbs.)None1st choice2nd choice3rd choice4th choice5th choiceSelect the dairy/frozen items you would likeMilkEggsYogurtCheck the appropriate box if you need diapers for a member of the household.Baby DiapersAdult DiapersEnter the diaper size and gender for the baby *Enter the diaper size and gender for the adult *Do you need Baby Food? (if yes, please plan to come in and select)YesNoAre 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
