Are you a Wisconsin resident?

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.

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.

We’re seeing a higher than usual demand with online orders and our space is limited. Once we reach our maximum number that we can store for that day it not be available for order.

When will you pick up your order?

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?

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,only ONCE per month.

Would you like cold cereal?

Would you like oatmeal?

Would you like canned fruit?

Items?

Would you like dried fruit? (PICK ONE)

Would you like soup?

Would you like Canned Beans?

Would you like dried ?

Would you like Rice?

Would you like a Bean and Rice Kit?

Would you like ?

Would you like instant potatoes?

Would you like Canned Vegetables?

Would you like Mac and Cheese?

Would you like peanut butter, jelly, etc?

Would you like dog food or cat food? ( if available )

Would you like snacks and sweets? ( if available )

Would you like Assorted Bread, rolls, and buns?

Would you like Eggs, if available?

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

Would you like frozen liquid eggs?

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

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

*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

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.