Gather Stock Box Order Form

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****ATTENTION**** DUE TO LOCAL EVENTS IN EAST COUNTY AND A LACK OF DELIVERY DRIVERS,

WE WILL BE UNABLE TO DELIVER FOOD BOXES FOR ALL ROUTES OFF OF HIGHWAY 12 EAST.

DELIVERIES WILL RESUME NEXT WEEK.

CHEHALIS DELIVERIES WILL BE DONE ON FRIDAY DUE TO DRIVER SHORTAGES

** ORDER BEFORE 8:00 AM TO ENSURE DELIVERY ON THE DAYS LISTED BELOW **

THURSDAY - I-5 Corridor:

FRIDAY - East Lewis County, Hwy 12 & South County:

Cinebar, Ethel, Glenoma, Morton, Mossyrock, Onalaska, Packwood, Pe Ell, Randle, Salkum, Silver Creek, Toledo, Vader, Winlock.

FOR ASSISTANCE CALL (360) 827-0264 option 3 or email stockbox@gatherchurch.com

NAME *

First and Last

STREET ADDRESS *

Example: "1234 MAIN ST"

UNIT NUMBER (optional)

Unit #, apt #, or space #

CITY *

Cities in our service area

WOULD YOU LIKE YOUR ORDER TO AUTO-REPEAT WEEKLY? *

If "Yes", order will auto-repeat weekly until cancelled at 360-827-0264 option 3 or stockbox@gatherchurch.com - PLEASE DO NOT REORDER WEEKLY

Yes

PHONE NUMBER

Ten digits - no spaces or dashes - example: "3609991234"

MAY WE TEXT YOU AT THE ABOVE NUMBER?

Yes

Clear selection

EMAIL ADDRESS

HOW SHOULD WE CONTACT YOU? *

Text / SMS

Phone Call

NUMBER OF PEOPLE IN HOUSEHOLD *

1 to 4

5 to 9

10 +

DO YOU HAVE THE MEANS TO COOK? *

Yes

OPTIONAL COMMENTS

** WE ARE UNABLE TO ACCOMMODATE ALLERGIES - ALL BOXES ARE STANDARDIZED **

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