Rhinelander Area Food Pantry Food Box Order Form

Rhinelander Area Food Pantry

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

To register, the head of household must provide proof of residency in Oneida County, and the names and birthdates of all household members.

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? Wisconsin residents that live outside of Oneida County are eligible to receive a prepackaged monthly box of food from the Emergency Food Assistance Program (TEFAP) on a first come, first served basis.*

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?*

Monday November 17th , 2025 - 3 pm to 5 pmWednesday November 19th , 2025 - 4 pm to 6 pmSaturday November 22nd , 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 eligibility,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 Peaches2 Elbow Noodles2 Spaghetti Sauce2 Light Red Kidney BeansInstant Mash potatoes2 Vegetable SoupChili PouchPeanut Butter2 Shelf Stable MilkJuiceBongards CheesePork ChopsCanned Beef
Please select the Holiday Food Items you would like below:

Please select either Ham or Turkey ( not both )

** Food items on the order list are subject to change and may not be available at the time your food box is packed. **
Holiday Food Items:

2 StuffingBroth or GravyCream of Mushroom2 Green BeansYamsCranberry SaucePumpkinEvaporated Milk or Condensed MilkHamTurkeyFlourSugarNutsBaking Mix
Would you like cold cereal?

YesNo
Would you like canned fruit?

PeachesApple SauceNone
Would you like dried fruit?

RaisinsPrunes
Would you like Pasta?

YesNo
Would you like Pasta Sauce?

YesNo
Would you like Canned Beans?

PintoGarbanzo BeansBlack BeansVegetarian 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?

BeetsCornDiced TomatoesSauerkrautAll
Would you like soup?

Vegetable SoupChili PouchBoth
Would you like canned meat?

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

Spice PouchGreen Enchilada SaucePeanut ButterJellyShelf Stable MilkRaisins
Would you like dog food or cat food? ( if available )

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

SnacksSweetsBeverages
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 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 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
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.