For Food Not Bombs to fill out Neighborfood Express
Note: They only do deliveries to Raleigh addresses unfortunately
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Understanding *
Do you understand that by filling out this form you will be contacted by one of Neighborfood Express' social work team to provide case management support for you along with your groceries. 
First name *
Last name *
Phone number *
Address *
Full address including apartment or hotel room number if applicable
Email *
Contact *
What is the best way to contact you?
Deliveries *
How often do you want to receive groceries and supplies?
People *
How many people are you requesting groceries for?
Availability *
Deliveries will be made between 10 am and 12 pm. Will someone be home during this time to receive the items?
Allergies/dietary restrictions *
Other assistance *
Do you need free assistance in any of the following areas? 
Required
Sharing *
Do you give the Marcus Harris Foundation permission to share your name and contact info with other partner agencies to assist you with the services above?
Pet food *
Do you want to receive free pet food?
https://chriscares.org/pawpantry-express
Computer *
Do you want to apply for a low cost desktop or laptop computer?
Computer - kids *
If you have children between the ages of 5-18, do you want to receive a free computer for them?
Infant/Toddler supplies *
Do you want to receive free infant/toddler supplies? (diapers, pullups, wipes, diaper cream, ointment, etc)
Diaper sizes
What sizes?
Books
If you have children between the ages of 0 - 12, do you want to receive free books for them?
Clear selection
Ages
How old are your children you want books for? Please indicate their ages separated by a comma
Details
Any other details you want them to know?
Submit
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