Care Pantry Program Contactless Pick Up Order Form
Hello, Thank you for starting the online process to receive your Care Pantry Items. Below are questions that will help us better serve you and the community. Please complete the form. After you fill out this order request, we will contact you to go over details and availability before the order is prepared. We now offer a Pickup location for faster service and have discontinued our delivery service. If you would like faster service please use the soonest available date for pickup. For any questions or concerns please contact us at Services@YouSaved.me
Place your Full Name and Online Food Pantry Order in the email subject line (Ex. John Smith Online Food Pantry Order) and we will respond as soon as possible. Thank you!
* Required
Email address
*
Your email
Contact info
We do not sell your contact information. We store it securely in our cloud to help better serve you now and in the future.
Are you a new or existing client?
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I am a new client.
I am an existing client.
First Name
*
Your answer
Last Name
*
Your answer
Address (If Unsheltered a location we can deliver to you.)
*
Your answer
Apt #
Your answer
City
*
Your answer
State
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California
Other:
Zip Code
*
Your answer
Phone number
*
Your answer
Preferred contact method
*
Phone
Email
Required
Refrigerated & Perishable Items Are for Pick Up Orders Only. Availability is limited. These items sell out fast and are not guaranteed. Availability based on Food Bank inventory.
Milk
Eggs
Chicken
Beef
Salads
Fruits
Snacks
Which food pantry items would you like to order?
*
Green String Beans (Canned)
Campbell's Chicken Noodle Soup
Canned Tuna Fish
Black Bean (canned)
Fruit Snacks
Long Grain Rice
Yellow Split Peas
Lentils
Sugar Cookie Mix
Stuffing Mix
Instant Cup of Soup
Healthy Choice Chicken Noodle Soup
Box of Spaghetti
Shells and Cheese
Penne and Cheese
Required
We only offer Pick-Up at this time. Pick up location is are located across from 5450 University Ave San Diego at the Northgate Market Parking lot on Tuesday, Wednesday and Friday’s. More Pick up locations coming soon. Look for our Black Canopy and Banner to find us. Which day will you pick up between 11 AM - 1 PM?
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Tuesday
Wednesday
Friday
To Book Your Pick-Up Appointment follow this link
https://fb.com/book/YouSavedMeFoundation/
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Yes, I booked a Pick-Up Appointment
No, I did not booked a Pick-Up Appointment
Age
*
16-24
25-40
41-55
55-64
65+
How did you Hear About Us?
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Face Book
Twitter
Google
Yelp
IG
Other
Gender
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Female
Male
Non Gender Conforming
Trans To Female (MTF or Male to Female)
Trans To Male (FTM or Female to Male)
Prefer Not to Say
Other:
Racial Background
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Asian
Black
Hispanic & Latin(x)
Multi-Racial/Mixed
Native American
White
Declined to Answer
Are You a Veteran?
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Yes
No
Do You Have any Income?
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Yes
No
Where does the Income come from?
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Government Assistance
Employed
Retired
Disabled
Family/Friends
No Income
How much is Your Monthly Income?
*
Your answer
How many dependents do you have?
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0
1
2
3
4 or more
Any Physical Disabilities?
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Yes
No
Any Developmental Disability?
Yes
No
Clear selection
Any Chronic Health Conditions?
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Yes
No
Other Program(s) of Interests?
Check all that apply and Please fill out a seperate application form for the Program you wish to be accepted into below. You can do that by going to each of the Programs Pages from
www.YouSaved.me
Month Supply of Baby Diapers and Wipes
Month Supply of Pet Food
Emergency Homeless Care Kit
Care Plate Program
Other:
We deliver within 48 Hours of Approval. Is that ok? We will also call you to confirm the date, location, and time of delivery.
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Yes
No
Time of Day you're available on the date of delivery?
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9:00 AM -12 PM
1:00 PM - 3:30 PM
Day Available to Pick Up Food Pantry Order? You will be contacted with your appointment time and location to pick up your order.
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Tuesday 11AM-1PM (choose this date if ordering any perishable or refrigerated items)
Wednesday 11AM -1PM
Friday 11AM -1PM
All of our forms and services are online. The best way to stay up to date and help continue our programs will be to Follow us on our social media. You can choose either or all by following us to Facebook, Twitter, Instagram, and YouTube! This will always ensure you stay up to date on the latest Events and Programs! You can follow the links below or from our website by clicking on the social media icons in the footer of each page. Please Follow so we can help our neighbors live healthier, less stressful lives. Check all that apply below.
*
Followed You Saved Me Foundation Facebook Page
https://www.facebook.com/YouSavedMeFoundation
Followed You Saved Me Foundation Twitter at
https://twitter.com/ysmfoundation
Followed You Saved Me Foundation Instagram Page at
https://www.instagram.com/yousavedmefoundation
Followed You Saved Me Foundation YouTube Page at
https://www.instagram.com/yousavedmefoundation
Subcribed to our YouTube Page at
https://www.youtube.com/channel/UC3pXcwNUHRT-LtEEtyQyTbA
I have not followed any social media for You Saved Me Foundation
I opt out of Social Media Following.
Required
Any comments or questions?
Your answer
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