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WCHS Food Pantry Form - Family size 3-5
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 Area school districts only *
Number in family *
Dietary Needs - Please indicate below if you need sugar free, gluten free or have any allergies.
Grains - Pick 6
Fruit - Pick 6
Vegetables - Pick 6
Protein - Pick 3
Boxed meals and soups - Pick 6
Beverages -As Available- Pick 2
Snacks- As Available - Pick at least 1
Baking Supplies As Available- Pick 2
Extras - as available
Frozen Meats - As Available- Pick 2
Fresh Produce - as available
Dairy - as available
Household goods - as available
Toiletries - as available
Baby items- Need to be a diaper bank client
Baby wipes
Clear selection
Diapers - add size below (Delivery only with food items)
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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