Welcome to the McDonald Meals on Wheels Registration Form. Please fill this out and one of our staff volunteers will contact you to get started.
Client Details:
Name of Recipient
*
First Name
Last Name
Address for Service
*
Street Address
Apt or Room Number / Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
example@example.com
How many days of the week are you interested in receiving a meal at $6 per day, Monday through Friday?
Additional information? Allergies? Diabetic? Low Sodium? Gluten Free? List them here.
Do you have any special delivery instructions? Please let us know. (i.e.: which door to use.)
Submit
Should be Empty: