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WCHS Food Pantry Form - Family size 6-10
Food Bank Request Form for our INCOME QUALIFIED neighbors.

Please call our office (717-762-6941) within 1 week to set up an appointment for pick up or this order will be canceled.  All orders not picked up within 24 hours of your scheduled appointment time will be put away unless other arrangements have been made.
Email *
Name (first and last) *
Phone Number *
Full Address - Food bank is open to residents of the Waynesboro Area school district or Greencastle school district only. *
Number in Family *
Dietary Needs - Please indicate below if you need sugar free, gluten free, or have any allergies
Grains - Pick 8 *
Required
Fruit - Pick 8 *
Required
Boxed meals and soups - Pick 8 *
Required
Protein - Pick 4 *
Required
Vegetables - Pick 8 *
Required
Extras - as available
Snacks - As Available - Pick at least 1 *
Required
Beverages -As Available- pick 2
Baking Supplies - As Available - Pick 2
Frozen Meats - As Available- Pick 2 *
Required
Fresh Produce - as available
Dairy - as available
Household goods - as available
Toiletries - as available
Baby Food- As Available
Depends - add size below
A copy of your responses will be emailed to the address you provided.
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