LUNCH BREAK DRIVE REGISTRATION FORM
Thank you for your interest in organizing a Drive to benefit Lunch Break.
Types of Drives:
- Back To School (Program)
- Food Drive (Food Drive, etc.)
- Clothing (Program)
- New Toys Drive (Program)
- Toiletries/Hygiene, Pampers, Wipes, etc.(Food Drive)
Millie Jeter (Food Drive Director): email www.mjeter@lunchbreak.org or 732-747-8577 x 3102
Melia Owens (Program Coordinator): email www.mowens@lunchbreak.org or 732-747-8577 x 3022
To have any request for written acknowledgement of community service hours you must register your drive in advance and a copy must be submitted to Peg Rizzo at prizzo@lunchbreak.org.
Contact Information
Organization: _____________________________________________________________________
(if Applicable)
First Name: _________________________ Last Name: _____________________________
Street #: ________ Street name: _____________________________________________
City: ____________________________ State: _______ Zip Code: _____________
Email address: _______________________________________________________________
(please print)
Phone #: Private: ________________________ Business: __________________
Drive Information
Today's Date: _________________
Drive Date: Start: _________________ End: _________________ If applicable
Requests: Lunch Break tour: YES _____ / NO _____
Speaker: YES _____ / NO _____
Date you deliver your donations: _________________Time:_______________
Thank you for including transportation
Internal Purpose Food Weight |
|
Number of hours worked on the Drive _______________________
121 Drs. James Parker Boulevard / PO Box 2215 / Red Bank, NJ 07701
Phone: 732 747 8577 / Fax 732 383 8032)