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
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!
Email address *
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? *
First Name *
Last Name *
Address (If Unsheltered a location we can deliver to you.) *
Apt #
City *
State *
Zip Code *
Phone number *
Preferred contact method *
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.
Which food pantry items would you like to order? *
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? *
To Book Your Pick-Up Appointment follow this link *
Age *
How did you Hear About Us? *
Gender *
Racial Background *
Are You a Veteran? *
Do You Have any Income? *
Where does the Income come from? *
How much is Your Monthly Income? *
How many dependents do you have? *
Any Physical Disabilities? *
Any Developmental Disability?
Clear selection
Any Chronic Health Conditions? *
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
We deliver within 48 Hours of Approval. Is that ok? We will also call you to confirm the date, location, and time of delivery. *
Time of Day you're available on the date of delivery? *
Day Available to Pick Up Food Pantry Order? You will be contacted with your appointment time and location to pick up your order. *
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. *
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