Where are you located?

North CountySouth County

Organization Name

Number of Employees/Members

Street Address

City

State

Zip Code

Contact First Name

Contact Last Name

Contact Phone

Contact Alternative Phone

Contact E-mail

Start Date

End Date

Number of Barrels Requested
(1 barrel holds 150 pounds of food - Only Corporate Challenge partners, grocery stores, and schools donating over 500 pounds will get barrels - everyone else will need to use food boxes or their own containers)

Number of Food Boxes Requested
(1 box holds 50 pounds of food)

Number of Cash Boxes Requested
(For every dollar donated, we can provide 8 healthy meals to those in need)

Will you be picking up your own food & funds drive supplies at our warehouse?
(South County Warehouse prefers the community to do pick-ups Wednesdays from 1:00-3:00pm)
yesno

Will you need to schedule barrel or food drop-offs or pick-ups?
(We have to recruit volunteers to drop off barrels or pick-up food for you if you cannot do this yourself)
Drop-offsPick-UpsNone

If you need us to drop-off/pick-up, what are your days and hours of operation?

Instructions for Driver at destination

Notes