Order Request Form
Read through each section's directions and allotted points information carefully. Any substitutions needed to be made based on availability will be at the discretion of the fulfillment volunteer unless otherwise noted at the bottom of this form. 

Each order can equal 20 Points TOTAL. Items/Points will be counted in form order. Any additional points selected beyond 20 will not be fulfilled. 

Orders can be picked up on Fridays from 3:00-3:30pm at the Food Pantry Location (see below image).  

Online orders MUST be placed by Wednesday at 3:15pm in order to be fulfilled for Friday pick-up. 

Email the Pantry at bcsc_eastfoodpantry@bcsc.k12.in.us if you have any questions or need to arrange a different time for order pick-up. 
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Pantry is located behind the library, near door 31 (across from tennis courts) inside East High School.
DO YOU WANT ONE (1) OF THE FOLLOWING ITEMS?
(DOESN'T COUNT TOWARDS YOUR 20 POINTS - WHILE SUPPLIES LAST)
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PORK CHOPS - 1 LB PKG = 1 PT (LIMIT 2)
FROZEN MEAT CONTINUED
(EACH ITEM HAS A LIMIT OF 1)
CANNED MEAT 
SNACKS
(LIMIT 2 POINTS) (ALL ITEMS LIMIT 1 EACH)
MARGARINE - 1 LB (LIMIT ONE)
AMERICAN CHEESE SLICES - 1 LB (LIMIT ONE)
SWEET CORN - 15 0Z CAN
CUT GREEN BEANS - 15 OZ CAN
MIXED VEGETABLES - 15 OZ CAN
SWEET PEAS - 15 OZ CAN
SLICED CARROTS - 15 OZ CAN
PUMPKIN - 15 OZ CAN
DARK RED KIDNEY BEANS - 15 OZ CAN
PINTO BEANS - 15 OZ CAN
DRY PINTO BEANS - 1 LB BAG
BLACK BEANS - 15 OZ CAN
BAKED BEANS - 15 OZ CAN
GARBANZO BEANS (CHICK PEAS) - 15 OZ CAN
SLICED PEACHES - 15 OZ CAN
STRAWBERRY APPLESAUCE - 4.5 OZ CUPS
(6 FOR 1 POINT)
MANDARIN ORANGES - 11 OZ CAN
FRUIT COCKTAIL/MIXED FRUIT - 15 OZ CAN
APPLESAUCE - 15 OZ CAN
PEANUT BUTTER & JELLIES
(LIMIT 1 EACH)
VEGETABLE SOUP (CONDENSED) - 10.5 OZ CAN
CREAM OF MUSHROOM (CONDENSED) - 10.5 OZ CAN
CHICKEN NOODLE SOUP (CONDENSED) - 10.5 OZ CAN
TOMATO SOUP (CONDENSED) - 10.5 OZ CAN
PANCAKE MIX - 14 OZ POUCH
PANCAKE SYRUP - 24 OZ BOTTLE
CRISPY RICE CEREAL - 17 OZ BAG
QUICK OATS - 8.8 OZ BAG
OAT RINGS CEREAL - 17 OZ BAG
HONEY TOASTED O'S CEREAL - 17 OZ BAG
CORN FLAKES CEREAL - 17 OZ BAG
FRUIT RINGS CEREAL - 17 OZ BAG
(LIMIT 1)
RANCH DRESSING - 16 OZ BOTTLE
ITALIAN DRESSING - 16 OZ BOTTLE
BARBECUE SAUCE - 18 OZ BOTTLE
KETCHUP - 50 OZ BOTTLE
ROASTED CHIPOTLE SALSA - 16 OZ JAR
MICROWAVEABLE CONTAINERS = 2 FOR 1 POINT (LIMIT 2 POINTS)
CORNED BEEF HASH - 15 OZ CAN (LIMIT  1)(*NOT MICROWAVEABE)
BEEF STEW - 7.5 OZ CAN = 2 FOR 1 POINT (LIMIT  4)(*NOT MICROWAVEABE)
WHITE RICE - 1 LB BAG
(LIMIT 2)
READY RICE (CILANTRO LIME) - 8.5 OZ POUCH (LIMIT 2)
MACARONI & CHEESE DINNER - 7 OZ BOX
(LIMIT 2)
LASAGNA SKILLET DINNER - 5.6 OZ POUCH
(LIMIT 2)
BEEF  FLAVOR SKILLET DINNER - 5.6 OZ POUCH (LIMIT 2)
ALFREDO SKILLET DINNER - 4.4 OZ PKG
BEEF RAMEN - 3 OZ PKG
(2 FOR 1 POINT)
SOUP AND OYSTER CRACKERS - 9 OZ PKG (LIMIT 2)
AU GRATIN POTATOES - 4.4 OZ PKG
YELLOW CAKE MIX - 9 OZ BOX
(LIMIT 2)
BROWNIE MIX - 8 OZ PKG
ALL-PURPOSE BAKING MIX - 14 OZ BOX
(LIMIT 2)
INSTANT MASHED POTATOES - 6 OZ PKG
(LIMIT 2)
THIN SPAGHETTI - 1 LB PKG
(LIMIT 1)
CORN MUFFIN MIX - 7.5 OZ PKG 
SALTINE CRACKERS - 8 OZ BOX (2 SLEEVES)
PASTA SAUCE - 15 OZ CAN
WIDE EGG NOODLES - 16 OZ BAG
(LIMIT 2)
SHELF-STABLE 1% WHITE MILK - 32 OZ BOX
(LIMIT 1)
SINGLE-SERVE MICROWAVEABLE MACARONI & CHEESE - 2 OZ BOX (4 FOR 1 POINT)
BOTTLED WATER - 16.9 OZ BOTTLE (6 FOR 1 POINT) (LIMIT 1)
ANTIBACTERIAL BAR SOAP - 3 BAR BOX
PAPER TOWEL - SINGLE ROLL (LIMIT 1)
LAUNDRY DETERGENT - 32 OZ BOTTLE 
(LIMIT 1)
TOILET PAPER - 4 ROLL PKG (LIMIT 1)
POTATOES - 10 LBS (NO POINTS!)
APPLES - 4 LBS (NO POINTS!)
ONIONS - 3 LBS (NO POINTS!)
In the event that substitutions need to be made, please type below up to TWO ITEMS that you would prefer we substitute with if able. 
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