Food Basket Request Form

 

The Cornucopia Food Pantry provides food baskets upon request for those in need.  These baskets have a variety of wholesome and nutritious foods, including gift certificates for you and your family.  If you would like a basket, please complete, and cut out, the form below.  Then send it directly to the Waysmeet Center at 15 Mill Road, Durham (you can use UNH campus mail as well).  You can also e-mail the same information to us at Waysmeet@comcast.net or Larry.brickner-wood@unh.edu. 

 

The Cornucopia Food Pantry is currently open every day and we are located at The Waysmeet Center on 15 Mill Road in Durham NH. If you have any questions please feel free to call us at 862-1165.   Peace to you and your loved ones.

 

Sincerely,

Rev. Larry Brickner-Wood, Chaplain and Executive Director

 

è Cut Out Form Below ç

 

Cornucopia Food Basket Request


[   ] Yes, I would like a basket for:

Text Box: The following Date (MM/DD/YYYY): _______________________________ I would like a basket but please make it vegetarian ______________________ Number of people Served: _________________________________________  

 

 
 

Specific food items requested: ________________________________________________

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Will you pick the basket up at the Waysmeet Center? 

Yes [  ] No [   ] or delivered to you? [   ]

Is there anything else you need at this time?  _____________________________________

Text Box: Contact Information Contact Name: ____________________________________________________________ Address: _________________________________________________________________ Address: _________________________________________________________________ Phone number: ___________________ Email: ___________________________________

 

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