Estacada Area Food Bank Shopping Order Request
RESIDENTS of Whispering Pines and 300 Main - do NOT fill out this form. Please contact your building manager.

All other customers: Please fill out the following shopping list. We will do our best to honor your request. We currently do not have as much control over our food supply. Some items may not be available or are in limited supply. At our discretion, we may substitute a like item. If you receive something you cannot use, please pass it on to someone in the community. Thank you.

Experiment with new foods! Stay connected with our web page and Facebook page - we are working on ways to demonstrate possibilities of foods you may not be used to using. Stay well!
Please tell us if you are a new or existing customer. *
Please provide us below: Your first name, last name, birth date, a phone number (if you have one) & email address (if you have one) where we can reach you. *
Your answer
Please tell us how many adults and how many children are in your household. Example: 1 adult/2 children *
Your answer
Are you age 60 or older? *
Please tell us if a family member has a compromised immune system. *
WE WILL MAKE EVERY EFFORT TO HAVE YOUR ORDER READY WITHIN 48 HOURS. Please provide us with the day & time during our open days & hours, A MINIMUM OF 48 HOURS AFTER SUBMITTING YOUR ORDER, when you can pick up. A friendly volunteer will contact you when your order is ready. PLEASE DO NOT CONTACT US UNLESS YOU HAVE NOT HEARD FROM US IN 48 HOURS. Thank you for your patience. *
Your answer
Preferred contact method:
PRODUCE
DRY GOODS
FRIDGE & FREEZER
EXTRAS
SNACKS
Questions and comments
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy