BCS Cares Request
Badge Number
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Date
*
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Month
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Day
Year
Date
Phone Number
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Please enter a valid phone number.
# of adults in the household
*
Children in the Household
*
How many days of food do you need?
*
If you need more than 10 days of food, please tell us how many days you need and briefly explain your circumstances.
Where would you like to pick up your food?
*
Please Select
The Well: Pastoral Support Center
Snack Pak 4 Kids Warehouse (2406 SW 3rd)
Other
Choose 4-5 Protein items.
Mexican Chili Beans (can)
Tuna Lunch To-Go
Chicken (can)
StarKist Chunk Light Tuna
Chicken Noodle Soup - Progresso
Spaghettio's
JIF Peanut Butter
Beef Ravioli (can)
Pinto Beans (can)
Rosarita Refried Beans (can)
Pinto Beans (dry bag)
Wolf Brand Chili (can)
Choose 2-3 Vegetable Items
Corn
Green Beans
Spaghetti Sauce
Mixed Vegetables (can)
Choose 1-2 Beverages
Chocolate Milk
Gatorade
Choose 2-3 Fruits
Mixed Fruit Cocktail
Pineapple Chunks
Mandarin Oranges
Peaches
Choose 3-4 Grain Items
Quaker Instant Oatmeal (variety)
Assorted Cereal (2 ounce package)
Long-Grain Rice (1 pound bag)
Spaghetti Noodles
Ramen Noodles (chicken flavor)
Kraft Mac & Cheese
Crackers (sleeve)
Pancake Mix
Choose 1-2 Snack Items
Peanut Butter Crackers
Beef Sticks
Cheez-Its Crackers
GoGo Squeeze Applesauce
Pop-Tarts - Strawberry
Nature Valley Protein Bar
Other
$20.00 United Supermarkets Gift Card* (for perishable items like bread, meats, cheese, fresh vegetables/fruit, etc.) *Annual gift card limits apply. Gift card requests are subject to approval.
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