Clone of Food for pick up for 1/7 & 1/9

Food Pickup

Pick up for 1/14 & 1/16

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Have you been to the Antigo Community Food Pantry before? Are you a REGISTERED CLIENT?

YesNo, I want to become a client of the ACFP. I have never been to the pantry. (Please call the pantry at 715-623-1103 Submitting an online order form does NOT mean you are registered. You must call the pantry BEFORE a distribution. Once we have all of your personal information in our system, you are then registered to obtain food. Thank you!)
Please submit orders for Wednesday by Monday at midnight and orders for Friday by Wednesday at midnight. This allows time for our volunteers to fill your orders.

If you don't, you will receive a standard box for your household size. Thank you!
What is your name (FIRST AND LAST NAME)?
What is your phone number? Please provide a working phone number. We need to be able to contact you about your order.
What is your email address?
If there have been any changes to your household (number of people, address change, new phone number, etc...) It is your responsibility to call the Pantry as soon as possible to get your information updated. You will only receive food for the number of people we show in our system.
How many people are in your household?
When will you be coming to the pantry to pick up your order?

WednesdayFriday
Will a proxy be picking up for you? If so, who? There must be a proxy form on file for anyone not on the account to pick up food for you.
Regular or low-salt diet?

Low-saltRegular
Would you like frozen meat?

No thank youYes please
Would you like bakery: sweets or bread?

No thank youBoth pleaseBread only pleaseSweets only please
Would you like fresh produce?

No thank youYes please
Please choose one.

CornGreen BeansMixed Vegetables
Would you like Sauerkraut?

No thank youYes please
Please choose one.

Garbanzo BeansPinto Beans
Please choose one.

Chicken Noodle SoupCream of Chicken SoupCream of Mushroom Soup
Please choose one.

Diced tomatoesSpaghetti Sauce
Would you like Mac and Cheese?

No thank youYes please
Would you like Rice and Beans?

No thank youYes please
Would you like Pasta?

No thank youYes please
Please choose one.

ChickenTuna
Would you like Rice?

No thank youYes please
Would you like Peanut butter?

No thank youYes please
Please choose one.

ApplesaucePeachesMixed FruitPears
Would you like Iced Tea?

No thank youYes please
Please choose one.

CerealOatmeal
Would you like Women's feminine products?

Liners
Would you like Men's Shields hygiene pads?

No thank youYes please
Do you have any comments?
Thank you for filling out this form! As stated above, we will do our best to fill your bags with the items you have selected but please remember that can change based on what we have in stock. Thank you!
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Food Pickup

If there have been any changes to your household (number of people, address change, new phone number, etc...) It is your responsibility to call the Pantry as soon as possible to get your information updated. You will only receive food for the number of people we show in our system.