Food Bank Order Form
Everyone accessing the Harvest Food bank MUST BE REGISTERED. You can now register online, but will still need to bring in a piece of ID to complete your registration. You can find the registration form on the Island Community Services website. Please have your orders in by Monday night at the latest!! Please note that orders submitted online will be ready for pick-up on Tuesdays between 10:30am. and 3:30pm. *PLEASE BRING BACK YOUR RE-USE BAGS SO WE CAN FILL THEM UP AGAIN!*
Personal Information
Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I will be picking up
*
Yes
No
Group Delivery - if registered & approved
Group Delivery Location Code
*
MG
FP
Volunteer Driver
YOU MUST BE APPROVED & REGISTERED FOR GROUP DELIVERY
Pick-up person's name
*
If other than yourself
Number of Adults in this food order(18+)
*
Number of Children in this food order
Leave Blank if none
Total number of people in this food order
Ages of Children
*
Between 0-5yrs
Between 6-12yrs
Between 13-17yrs
Household Members
Do you Have access to cooking facilities?
*
Yes
No
Do you have any dietary preferences?
Meat
Vegetarian
Vegan
Other
Do you have any allergies we should know about?
Leave blank if none
Food Bank Order
SELECT ALL ITEMS YOU ARE WILLING TO RECEIVE. Please note that all items are subject to availability and a selection will be made based on your household size.
Canned Goods
Protein
Peanut Butter
Canned Fish
Canned Tuna
Canned Beans
Chickpeas
Red Kidney Beans
Black Beans
Baked Beans (vegetarian)
Canned Vegetables
Sweet Corn
Green Beans
Other Canned Goods
Chili (meat)
Pasta Sauce (vegetarian)
Fresh Produce
Fruits
Bananas
Orange
Vegetables
Potatoes
Carrots
Onions
Farm Fresh Produce
Dairy and Alternatives
Protein
Eggs
Tofu
Dairy or
Margarine
Alternative Milk
Check here if you would like your alternative milk to be chocolate
Bread and Alternatives
Please choose one, depending on availability a substitution may be made.
Bread Products
Bread/Buns
Bagels
Dry Goods
Please choose one in each category, depending on availability a substitution may be made.
Pasta
Pasta
Dried Beans/Legumes
Lentils
Chickpeas
Rice
White Rice
Oats/Other Grains
Rolled Oats
Instant Oats
Gluten Free Oats
Flour
All Purpose Flour
White Bread Flour
Sugar
White Sugar
Artificial Sweetener
Beverages
Black Tea
Coffee
Other Dry Goods
Béarnaise or Cheese or Gravy Sauce Packet
Extras
Please select any extra items you would like to receive. There is a limit of 2 extra items per person and a selection will be made based on availability and household size.
Extras
Assorted Chips
Microwave Popcorn
Baklava
Kids Snacks
Tinned Fruit
Salad Dressing
Mystery Indian or Asian Fixings
Mystery Soup
Personal Hygiene/Household
Household
Sanitary Pads
Regular
Tampons
Regular
Incontinence Underwear or Adult Diapers
Depends size extra large
Overnight Incontinence Pads
Baby Supplies
Baby Food and Diapers (for diapers please specify size in comments, newborn to size 6)
Baby Food
Diapers
Pet Supplies
Pet Food
Dog Food
Cat Food
Anything else you would like to tell us?
All the items listed above are subject to availability and quantities will reflect household size. Not everything selected may be included in the order. In order to receive food hampers from the food bank, recipients need to register. This quick process can be done on your first visit. Please bring a piece of ID if you have not yet registered.
*
I understand
SUBMIT YOUR ORDER
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