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Form: Retail Pick Up Form

"*" indicates required fields

If you are weighing your own items, enter "yes", if you are counting your items, enter "no". It helps a lot with our calculations.
List Items Here
Please enter the number of boxes you receive of each item in the appropriate boxes. If you have multiple pick-ups from the same location, press the (+) sign to add a new entry for each different date. The total weight will be calculated automatically.
Pickup Date
Bakery
Meat
Produce
Deli
Dairy
Frozen Grocery
Dry Grocery
Non-Food
 
List Item Weight Here
Please enter the pounds you receive of each item in the appropriate boxes. If you have multiple pick-ups from the same location, press the (+) sign to add a new entry for each different date. The total weight will be calculated automatically.
Pickup Date
Bakery
Meat
Produce
Deli
Dairy
Frozen Grocery
Dry Grocery
Non-Food
 
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Hidden
Hidden
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Weekday Hours
Office: 8am - 5pm
Receiving: 10am - 3pm click here to arrange for deliveries
Volunteers: 9a-12p • 1p-4p

Latest News

  • Food Insecurity During Thanksgiving November 23, 2022
  • Let’s make sure you’re still covered by Medicaid! June 7, 2022
  • A Day at Asbury Senior Safety Net May 20, 2022

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Form: Retail Pick Up Form

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