Hopewell Valley Council of Churches Volunteer Grocery or Medication Shopping Assistance Form
The Hopewell Council of Churches and Hopewell Gives Back now offers a grocery and medication shopping assistance program! How does this work? Write your grocery and/or medication list on the form and include the following information: quantity, item, and brand of each item. Next submit the form by either Monday, if you would like your groceries and/or medication delivered on Tuesday, or Wednesday if you would like your groceries and/or medications to be delivered on Thursday. Then on Tuesday and Thursday, volunteers will be visiting local grocery stores to help you in this time of need. A volunteer will be in contact with you to work out payment (cash or check) and delivery time/plans. You will only be responsible to cover the cost of the groceries. To make sure your groceries and/or medication get delivered on the day you would like submit the form the day before. All groceries and/or medication will be delivered by 5:00pm on Tuesday or Thursday. Please remember our grocery shopping assistance program is new and some items may be out of stock. We will do our best to get it right the first time, but we appreciate your flexibility and patience during this difficult time.
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Grocery List (make sure to include brand and quantity)
Submit
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