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Food Drive Registration Form

Please check all that apply

Yes! We want to hold a Food Drive:

Our Organization would like to match every pound we raise with $1.00:

Please select one of the following:

We would like to donate:

Dollar Amount :

Organization:

Contact Person:

E-mail Address:

Title:

Phone:

*Barrel Delivery Address:

City:

State:

Zip:

Mailing Address:

City:

State:

Zip:

How Many?

(Barrels come in two sizes. The small size holds about 100 cans, and the large size holds about 150 cans)

Large:

Small:

*Preferred delivery date :

*Preferred Pickup Date:

(Please try to avoid any Friday dates. Thank You!)

Barrel deliveries and pickups

Our drivers need to know where to deliver the barrels, (i.e. loading dock or "west entrance") and any building security protocol. Please note that drivers will deliver barrels to the building; we request that your company distribute them to specific locations, then bring them back to the original place for pickup:

Are you having a contest?:

NoYes- internal - no need to weigh barrels separatelyYes- and we would like you to weigh each team's barrel(s) separately

To do a contest, you will need to order barrels for each team; then mark each barrel (with paper or tape). Please indicate the barrel identification below: