Food Pantry Registration
Struggle of Love Foundation
Address: 12000 E. 47th Ave.
Contact us at: struggleoflovefoundation.org
Date *
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Head of Household First Name *
Your answer
Last Name *
Your answer
Address *
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Zip *
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Phone *
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Email Address
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Household size *
Your answer
# Seniors 60+ *
Your answer
# Adults 18-59 *
Your answer
# Children 0-17 *
Your answer
What items do you need? *
Required
Other please explain
Your answer
I understand that I am responsible for picking up my food order. *
Required
Pick up day *
MM
/
DD
/
YYYY
Pick up time *
Required
Thank you
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