Perry Road Baptist Church Food Pantry Order  Form
Fill out this form by 2 pm Tuesday for orders to be picked up Tuesday evening between 5 and 6:00 pm. You should already have submitted the Food Pantry Registration Form (one time). Submit a new order form each time you order.
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Email *
For Food Pantry Volunteers only. #'s______________
Date *
MM
/
DD
/
YYYY
Name *
(this should match the name you used on your registration form)
Number of Family Members *
Food Selection
Canned Vegetables
Canned Vegetables, Fruits and Tomatoes Section
This section contains canned Vegetables, Fruit, and Tomato sauces.
Canned/Dried Fruit
Soups and Broth Section - Please select no more than 4
This section contains canned Soups and Broth.
Soups
Condiments, Baking Products, and Beverages
Condiments - please select only (1) dressing
Pasta, Rice, and Breakfast Section
This section contains canned Soups and Broth.
Rice
Pasta
Pre-Packaged Items
Canned Pasta
Breakfast Items
 Hot Beverages
Snacks - pick 2
Proteins
Personal Hygiene - March 5
Paper Products - March 5
Cleaners - March 19
Baby Products - must be registered with a baby
Proteins - Please select according to your family size:  
This section includes Frozen Meats, Dairy and Canned Proteins
Frozen Meats
Frozen Foods
Dairy
A copy of your responses will be emailed to the address you provided.
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