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Food Pantry Request

  1. Please check off the items you would like (provided that we have them in stock).
  2. Vegetables
  3. Soups
  4. Beans
  5. Canned Items
  6. Starched Items
  7. Breakfast Items
  8. Personal Items
  9. Other Items
  10. Baby Items
  11. Leave This Blank:

  12. This field is not part of the form submission.