Chabad CAREs - Sign Up - February 10th
Thank you for your interest in the Chabad CAREs Kids Wellness Initiative. This form is for orders for January 27th

Please complete this form NO LATER THAN MONDAY, January 31st at 3:45 PM.

Lubavitch of Wisconsin, in collaboration with Gourmet Gorilla of IL, is happy to be able to provide kosher food for CHILDREN (18 AND UNDER) across the state without charge. Each Chabad House/Shul will serve as a delivery center for their community.

Please fill out this form to take advantage of this opportunity to receive food box(es) and/or milk for your family.

Please fill out ONE ORDER FORM PER HOUSEHOLD PER WEEK.

AS OF NOW - THESE BOXES WILL BE AVAILABLE ON THURSDAY, February 10th.
Email *
LAST Name *
FIRST Name *
Address (please include city state and zip) *
Please enter your complete address - including city state and zip
Cellphone Number to Contact You (XXX-XXX-XXXX) *
Which drop-off center/neighborhood route are you closest to? *
How many children in your family? *
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Lubavitch of Wisconsin.