Food Shelf Order Form

Food Shelf Order Form
Members of The Aliveness Project may submit this form to indicate grocery preferences before coming to pick up Food Shelf bags. Our hours are Monday-Wednesday-Friday from 11 am - 3 pm. You must submit your requests at least 48 hours (two business days) in advance to give us time to put your bags together.

Food Shelf groceries are limited to once per week, but members may get to-go meals every day we are open. We will do our best to honor your requests, but please note that it depends on having enough staff and volunteers. And since the Food Shelf operates on donations, we may need to make substitutions.

Thank you!
Name *

First Name Last Name
Member Number
Your four-digit access pass
How can we reach you? Please give us your phone number or email. *
Any Dietary Restrictions? Please note we cannot guarantee items, but will do our best.
Examples: Gluten Intolerant, Vegetarian/Vegan, Religious Restrictions (Halal, No Pork, etc.), Diabetic, Low Salt or Low Sugar Diet
What day are you coming to pick up these groceries?

Month Day Year
Aliveness is only open Monday-Wednesday-Friday from 11 am - 3 pm
Are you coming to pick up yourself? If not, please write who you are sending below. They must know your member number to pick up for you.

I'm coming
Vegetables (pick 4)

Corn Green Beans Peas Carrots Mixed Veggies
Fruit (pick 2)

Pears Peaches Apple Sauce Fruit Cocktail
Staples (pick as many as you like)

Tomato Sauce Diced Tomatoes Pasta Oatmeal or Grits Peanut Butter Breakfast Cereal Juice Coconut Milk
Canned Protein

Tuna (2 cans) Chicken (2 cans)
Rice (pick 1)

Brown White
Canned Beans (pick 2)

Chickpeas/Garbanzos Red Kidney Beans Black Beans Refried Beans
Dried Beans (pick 1)

Split Green Peas Split Yellow Peas Black Beans Navy Beans (white beans) Black Eyed Peas
Soup (pick 3)

Tomato Cream of Mushroom Chicken Noodle Vegetarian Chicken Broth Vegetable Broth Ramen Noodles
Condiments (pick as many as you like)

Sugar Salt/Pepper (if available) Pancake Mix Maple Syrup Vegetable Oil Mustard Ketchup Honey (if available)
Jelly (if available - pick 1)

Grape Strawberry
Salad Dressing (if available - pick 1)

Ranch Italian
Canned/Packaged Meals (pick as many as you like)

Beef Ravioli (1 can) Chili with Beans (1 can) Baked Beans (1 can) Mac & Cheese (2 boxes) Canned Pork (1 can)
Skillet Meals (pick 1)

Cheesy Tuna Beef Pasta Cheeseburger
Hygiene Items (pick as many as you like)

Shampoo Lotion Toothbrush Toothpaste Deoderant Razors Toilet Paper Paper Towels Kleenex Comb or Brush (if available)
Snacks (pick as many as you like)

Nutrigrain Fruit Bars (2 bars) Peanut Butter Crackers (2 packs) Popcorn (2 packs) Saltines (small handful)
Frozen Bag (bags vary, but typically include ground turkey or ground beef, butter, veggies, tortillas, and miscellaneous items )

Pork Poultry Fish
Culturally Specific Foods (pick as many as you like)

Fufu Flour White Gari Goat Meat Halal Beef
Should be Empty: