Receive a Lifeline rice & bean meal to serve your family or group!

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Sign up below to receive a rice & bean meal package in the mail. These are the same meals that Lifeline distributes around the world in our schools, clinics and with our ministry partners. These meals are also shared locally in the US/Canada with churches and food pantries.

1 meal package serves up to 6 people. You can request multiple packages based on the size of your family/group.

Please note that we can only mail the rice & bean meal package to locations within the US and Canada.

First name *

Last name *

Address *

City *

State/Province *

Zip/Postal code *

Country (Rice & bean meal can only be mailed within the US and Canada) *

Phone number (In case we need to contact you for any mailing questions/errors) *

Email (In case we need to contact you with any mailing questions/errors) *

How many rice and bean packages will you need for dinner? *

This meal is for my

Family

Community/small group

Bible class

Other

Clear selection

Comments

Submit

Clear form

Never submit passwords through Google Forms.

Forms

This form was created inside of Lifeline Christian Mission.