Little Red Box Survey
Grocery Store Survey
Email address *
Name *
Phone Number *
Where do you currently shop for groceries?
During Houston's stay-at-home order, would you be willing and able to pick-up your pre-selected groceries at the corner of Harrisburg and Sampson (across the street from the Second Ward Coffee Plant rail stop)? *
Would you be willing to pay (EBT or Debit/Credit), provided the food is priced at or below what you might pay at the grocery store? *
When is your Activation Day? *
What are your regular food/household grocery needs? (select all that apply) *
Required
What are the non-food items you would like to have in the Little Red Box grocery store? *
What type of bread? *
What type of cereal? *
What type of canned vegetables? *
What type of beans? *
What are the top 10 Items you would like to have in the Little Red Box Grocery Store? *
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