Oilfields Food Bank Hamper Request

Please complete the information below to request your hamper. When you are finished click on the Submit button to send us your form. You will receive an email confirming your request information.

If you do not receive an email, first check your Junk email folder. If it's not there, then try to submit a new request or contact the Food Bank at ofbhampers@gmail.com.

Submissions can be done any day up to Tuesday at 12:00 PM.

After we review your request, you will receive a call or email confirming your pickup time for Tuesday afternoon.

Name*

First NameLast Name

Street Address*

Street Address

Street Address Line 2

CityProvince

Postal Code

Mailing Address*

Mailing Address

Street Address Line 2

CityProvince

Postal Code

Phone Number*

Please enter your phone number.

Email *

Confirmation EmailPlease enter your email twice - we check that the entries match to make sure we have your correct address.

Is this your first time using this food bank?*

NoYes

How many people are in your household?

Number of Adults*

Number of Children*

If you have any food allergies please explain what they are?

Tell us what you need?*

Do You Have Pets You Need Food For?
If you have pets please tell us how many you have of each? The size of dogs is important and let us know about pets that are not cats or dogs. If your pets require specific allergy/brand preferences we cannot accommodate.

Enter the number of each that you have below:

Number of Cats

Number of Small Dogs

Number of Medium Dogs

Number of Large Dogs

Number of Other Pets

If you have "Other Pets" please tell us what you have?

Comments about your pet food needs?

Personal Information

Oilfields Food Bank keeps client’s personal information on file in a secure database. This information will not be disclosed to any third parties other than affiliated agencies or service partners that would reasonably expect it, except as required by law.

Please acknowledge that Oilfields Food Bank has your permission to store your personal information.

You have my permissionI have concerns at this time

Please verify that you are human*

Date

Request a Food Hamper