A Simple Gesture: Yes! I want to be a Donor
A Dulles South Food Pantry program.

By registering below, you are committing to fill the green bag with food donations and leave the bag on your porch no later than 8 AM on the dates indicated. A volunteer driver will collect the bag and leave an empty bag.

Please understand that as we begin the initial phase of this program we will need to spend some time sorting out our processes for collecting your donations. To that end, we will limit the initial collection to 50 donors. Our goal is to increase donors over time.

Thank you for your support! For more information please contact asimplegesture@dsfp.org.

First Saturday of each Even Month (no later than 8 AM)

April 6
June 1
August 3
October 5
December 7

February 1
April 4
June 6
August 1
October 3
December 5

Email address *
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Phone Number *
Your answer
Nearest Elementary School *
Used for organizing driver pickup routes.
Any other information we should know?
Your answer
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Dulles South Food Pantry, Inc.. Report Abuse - Terms of Service