ASI Food Pantry After-Hours Lockers
Name
*
First Name
Last Name
Student ID #
*
Sac State Email
*
Confirmation Email
Please re-enter your email. If you mistype your email, you won't receive a code for pick-up.
Phone Number
Please enter a valid phone number.
*
Please list any dietary restrictions we should know when preparing your items.
Pick any.
Chicken Stuffing Mix
Pick any.
Canned Diced Tomatoes
Canned Black Beans
Canned Tuna (Contains Soy)
Creamy Peanut Butter Jar
Cilantro Lime Rice
Canned Green Beans
Pick any.
1% Low Fat White Milk (Shelf-Stable)
COVID-19 Test Kits
Sweet and Salty Almond Bars
Sweet and Salty Cashew Bars
Almond Butter Bars
Fruit Roll-Ups
Mott's Fruit Snacks
Pick any.
White Long Grain Rice (Dry, 1 lb)
Black Beans (Dry, 1 lb)
Elbow Macaroni (Dry, 1 lb)
Pinto Beans (Dry, 1 lb)
Quick Oats (Dry, 1lb)
Chickpeas (Dry, 1 lb)
Pick any.
Boom-Chicka-Pop Popcorn
Would you like any safe sex supplies?
LifeStyles Latex Condom (Size Large)
LifeStyles Latex Condom (Size Regular)
LifeStyles Liquid Personal Lubricant (Water-based)
Do you need your locker to be below waist height?
*
Yes
No
Would you like us to put your items in a cardboard box or paper bags?
Yes
No
I understand that I must bring my own bag to pick up my items.
I understand
I understand that if I fail to fill out the provided cancellation form & fail to pick up within my appointment time, this will result in having to use the food pantry only in person.
*
I understand
I will pick up my order within 48 hours after receiving my code from LuxerOne and notify Food Pantry staff if I have any issues.
*
I agree
Submit
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