Appointment Scheduling Form

Valley Outreach Appointment Scheduling
- Please complete the form below to schedule your preferred appointment type: food, clothing, or both food and clothing.
- Appointments are scheduled in 15-minute blocks of time. You will begin shopping sometime within 15 minutes of your appointment time.
- The system allows you to schedule one appointment at a time.
- If you are coming with a group of people to shop, each person who needs to shop for food must schedule an appointment.
- If you have questions or need assistance, please contact us at 651-430-2739 or info@valleyoutreachmn.org.
Name *

First Name Last Name
Phone Number *
Email
example@example.com
Date

Month Day Year
Date
Combined Data
I would like to schedule an appointment for: *

Food Food and Clothing Clothing
Food
Date APPT

Month Day Year
Date
Time APPT

Hour Minutes

AM/PM Option
Food and Clothing
Clothing
Should be Empty:

Valley Outreach Appointment Scheduling