Know a NEEDY FAMILY that we can bless with a food basket?

1) Ask them if they would like to receive a basket?
2) Ask them if they’ll be home on Sunday, Dec 15th, between 3:00pm and 5:00pm.
3) Make sure you know their address, their phone number and the number of family members.
4) Complete and submit the form below.

NOTE: After 40 families we will begin a Wait List. We will deliver Food Baskets to those on our waitlist if we have enough to do so.

Name of Family to Receive a Food Basket

First Name

Last Name

Address, Phone Number & Number of People Living at this Address

Your Name, Email and Phone Number

We may need to contact you for more information about the family

Verification

Did you verify with the family that they would like a basket and that the information above is correct?

Yes

No

Delivery

Do you want to deliver a food basket to this family?

Yes

No