General Information

Organization*

Number of Participants

Address*

Address (cont.)

Cross Street

City*

, CA

Zip*

Telephone*

Fax

Coordinator*

Participation

Event Name*

Select Food From the Bar Full Plate Letter Carriers Other Other

Our organization would like to help the San Francisco Food Bank by (check all that apply):

Donating food in our own containers and delivering it to the Food Bank
Running a food drive using Food Bank barrels
Raising financial donations for the Food Bank's food supply and distribution program
Volunteering at the Food Bank
Participation in a Hunger 101 session

Our goal is pounds of food and/or dollars

Our organization will match contributions or make an additional donation to support the Food Bank. Please provide specifics:

Our organization would like to be listed as a public food drop-off site.

By becoming a Food Bank drop-off site, you will help feed more people throughout the year! We ask that all public drop-off sites place their barrel(s)on the first floor lobby or another location that is easily accessible to the public. Your location will be listed here.

Barrel Orders

Number of Barrels

Delivery date

day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 month Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec year 2010

Pickup date

day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 month Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec 2010

Additional pickup/delivery dates

pickup deliver barrels on (mm/dd/yyyy)

pickup deliver barrels on (mm/dd/yyyy)

Note: Our drivers make pickups and deliveries between 9 a.m. and 3 p.m., Monday through Friday, except holidays. If your barrels become more than 2/3 full, complete the Additional Barrel Request Form or call us to pickup the full barrels. Our barrels hold approximately 150 - 200 lbs. of food.

Delivery/pickup location

Main address
Following address

Special instructions for our drivers

Note: We will deliver barrels to the front lobby unless otherwise requested.

On-site contact
(if different from coordinator)

Other special instructions