Food Hamper Request Form

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Deliveries are on Tuesday's, Thursday's and Saturday's only. Request must be made BEFORE 5pm the day before.

PRIORITY: Individuals and families in ISOLATION will be prioritised first.

Food hamper INCLUDES:
Rice, Pasta, Flour, Fruit and vegetable cans, Long life milk, Tuna, Legumes/lentils, Sugar, Pasta sauce, Cooking oil, Tea bags/coffee and Chocolate/ biscuits.

We do NOT have fresh produce, meat or NON-food items.

The Islamic Council of Victoria is providing food hampers with non-perishable food items to those in need. If you are experiencing hardships have been advised to isolate and need us to send a food hamper (with non-perishable food items), please fill in the below.

Deliveries are on Tuesday's, Thursday's and Saturday's only. Request must be made BEFORE 5pm the day before. *

I understand.

I understand there is a delay and people/families in isolation will be prioritised however, deliveries may take 2-3 days due to high demand *

YES

First name *

Last name *

Number and street (food hamper will be delivered to you) *

Suburb *

Postcode *

Phone number *

Email address (To confirm the delivery date) *

Accommodation type *

Share house

Living alone

Family

A) Number of people in the household *

Other:

B) How many people in the house need food? (do not include yourself) *

Do you require any other assistance? (We will help refer you to a Muslim org for support other than food relief)

Have you been asked to isolate? (Food will still be delivered) *

Yes

I understand the hampers are already pre-packaged from the Halal Food Bank and contain the following items *

Yes

Submit

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