RARA Neighborhood Grocery Order Form
We are open for in-person shopping during our regular hours on Monday, Wednesday, and Thursday from 2:30-4:30pm and Saturday from 10am-12pm. If you are unable to come inside the building or don't have someone who can shop for you, we are offering limited scheduled pick-ups.

After you complete an order, we will contact you to schedule a specific pick-up time. Please fill out a separate order for each household. If you are picking up for multiple households, let us know when we reach out to schedule your time slot.

Please let a volunteer know that you are picking up when you arrive.
Sign in to Google to save your progress. Learn more
First and Last Name *
Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
We will contact you to get any missing information and to schedule your pick-up time. If you do not have a phone number, write in "NONE." ***A volunteer will call you to schedule your time. Please make sure you check your voicemails!***
Email address
Number of People in Your Household *
Have you visited the Neighborhood Grocery (Food Pantry) in the last 2 years? *
You do not need to be an existing client. We do NOT require an ID or proof of income.
Address
Please provide your address if you have not been to the Neighborhood Grocery in the past two years, if you have recently moved, or if you need to request delivery.
What is your preferred pick-up date? *
A volunteer will reach out to you to schedule a specific time for pick-up. Please do not come to RARA until you are given a specific time slot to arrive. We have limited capacity for deliveries. Please try to find someone to pick up for you before asking for delivery. Deliveries may take up to a week depending on the availability of volunteer drivers. 
Are there any foods you do not eat due to allergies or dietary restrictions?
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy