Rhinelander Area Food Pantry Food Box Order Form

Rhinelander Area Food Pantry

Food Box Order Form
Rhinelander Area Food Pantry is a community pantry.

You must meet the income eligibility guidelines below to shop at RAFP.

Monthly Gross Income must be at or below the TEFAP Income Guidelines below: this is the gross income of the entire household; this includes all wages, social security, disability, pensions, child support and federal programs like W2.

If you have any questions contact RAFP at 715-369-7237 Monday through Friday 8 am to noon.
Are you a Wisconsin resident?*

YesNo
Do you reside in Oneida County?

YesNo
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
People in Your Household
How many people are in your household?   Number*
RAFP offers additional services:
The following questions are optional and will help to determine eligibility for the CFSP Senior Stock Box Program and other services. Your answers will also help RAFP to collect confidential data for grant writing and funding.
Please list all household members names and ages: Names and ages of all household members
Please note! Your order must be placed in advance of your pick up day.
- Orders to be picked up on Monday must be placed by midnight on Sunday.
- Orders to be picked up on Wednesday must be placed by midnight on Tuesday.
- Orders to be picked up on Saturday must be placed by midnight on Thursday.
When will you pick up your order?*

Wednesday September 17th , 2025 - 4 pm to 6 pmSaturday September 20th , 2025 - 9 am to 11 am
Will a proxy be picking up for you? If so, who?
** Please note, we do our best to keep this order form up to date. Food items on the order list are subject to change and may not be available at the time your food box is packed. **
Would you like a variety of fresh Fruits and Vegetables?

YesNo
Seniors age sixty and over who meet the income enigability,may qualify for a senior box thru CSFP program once a month.
CSFP Senior Box Choices: Age 60 and over only,once per month.

2 Cereal3 Cans Assorted Fruit2 Spaghetti Noodles2 Spaghetti SauceVegaterian BeansInstant Mash potatoesCanned Peas2 Vegetable Soup3 Chili PouchesPeanut Butter2 Shelf Stable MilkJuiceBongards CheeseHamburger Meat
Would you like cold cereal?

YesNo
Would you like canned fruit?

PeachesApple SaucePearsNone
Would you like dried fruit?

RaisinsNone
Would you like Pasta?

YesNo
Would you like Pasta Sauce?

YesNo
Would you like Canned Beans?

PintoGarbanzo BeansBlack BeansChili BeansAll
Would you like a Misc Item?

YesNo
Would you like a Bean and Rice Kit?

YesNo
Would you like Rice?

YesNo
Would you like instant potatoes?

YesNo
Would you like dried lentils?

YesNo
Would you like Canned Vegetables?

Green BeansBeetsCornDiced TomatoesPotatoesMixed VegPeasAll
Would you like soup?

Vegetable SoupAsst SoupBoth
Would you like canned meat?

YesNo
Would you like peanut butter, jelly, ketchup, or mustard?

Spice PouchPeanut ButterJellyShelf Stable MilkWasabi Beans
Would you like dog food or cat food? ( if available )

Dog foodCat food
Would you like snacks, beverages, and sweets? ( if available )

YesNo
Would you like Assorted Bread, rolls, and buns?

Bread onlyAssorted Buns & Rolls onlyBoth
Would you like Eggs, if available?

YesNo
Would you like Assorted Dairy items? *Items may include milk, eggs, yogurt, dips, cottage cheese, pudding, & cheese based upon availability.

YesNo
Would you like frozen Battered Pickle Spears?

YesNo
Would you like Frozen Meat? Choices are based upon availability each day and may not be available at the time your order is picked.

BeefChicken/TurkeyFishPork
Would you like frozen vegetables, pasta or fruit? ( if available )

YesNo
Would you like a miscellaneous frozen item? Items may include sandwiches, pastries, meals, pie crust, ice cream, etc based on donations

YesNo
*Please park in designated online order pick up spots at the north end of the building, and let the volunteers know that you have placed an online order.
Signature

Clear
Type a question
Should be Empty:

Rhinelander Area Food Pantry

*Please park in designated online order pick up spots at the north end of the building, and let the volunteers know that you have placed an online order.