Mobile Delivery Request Form (Only delivering to Waconia, Cologne, St.Boni, Minnestrista, Mayer, Watertown, New Germany, and Victoria)
How to Participate
1. Fill out this form by the 1st Wednesday of each month.
2.Wait for your delivery, which will take place the 2nd Wednesday of each month between 5-6:30pm
3. Unpack your groceries and find a new order form for the following month or come back to our website to complete a new form
4. Repeat steps 1-3
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Items will be delivered on the 2nd Wednesday of the month.  What month are you wanting food delivered: *
First and Last Name: *
Street Address (11 Main St.): *
City: *
Phone Number: *
Are you a new Shopper at Gather and Grow Food Shelf & Connection Center (aka Waconia United Food Shelf)? *
Family Size: *
Kids (Yes or No)
Clear selection
Apartment Complex: *
Would you like a reminder call on the date of your delivery? *
Mark any that apply: *
Required
Produce
Canned Vegetables (up to 5)
Canned Fruit (up to 5)
Grains (up to 4)
Proteins (up to 3)
Canned Beans (up to 4)
Frozen Meat (up to 3)
Healthy Meal Kit (changes monthly) *
Cooking (up to 5)
Baking (up to 4)
Boxed and Canned Meals (pick up to 4)
Snacks & Beverages (up to 4) *Not always available
Dairy (up to 4):
Bread:
Pet Food (up to 1 & if available):
Clear selection
Baby:
Miscellaneous:
Personal Care (Pick up to 3)
Household Items (Pick up to 3):
Other Section (Baby Formula Brand, Diapers and Depends sizes)
Other Item Requests (will do our best):
Submit
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