Date MM DD YYYY Name * First Name Last Name Phone * (###) ### #### Email Toilet Paper Yes Laundry Detergent Yes Facial Tissue Yes Paper Towels Yes Canned Soup Pick 1-2 Beef Broth Chicken Miscellaneous Tomato Vegetable Creamed Salad Dressing Mayonnaise Salad Dressing Peanut Butter Yes Seafood Yes Canned, Packaged or Boxed Milk Yes Jam Yes Canned Meat Pick one Chicken Spam Beef Ramen Yes Muffin Mix Yes Brownie Mix Yes Crackers Various types available Yes Canned or Boxed Potatoes White Potatoes Sweet Potatoes (Yams) Vegetable Oil Yes Baking Items (pick no more than 2) Flour Sugar Baking Spices Baking Soda Cake Mix Frosting Sweetened Condensed Milk Salt Miscellaneous Baking Items Canned Vegetables Pick up to 3 String Beans (Green or Yellow) Beets Carrots Corn Miscellaneous Peas Potatoes Juice Yes Canned Beans Pick one Baked White Black Chili Kidney Macaroni and Cheese Yes Cereal Pick one Cold Oatmeal Canned Tomatoes Yes Tomato Sauce Yes Tomato Paste Yes Condiiments Barbecue Sauce Ketchup Mustard Relish Pickles Pasta Sauce Yes Pasta Yes Pancake Mix Yes Syrup Yes Chef-Boy-r-Dee Yes Stuffing Mix Yes Canned Fruit Applesauce Pears Peaches Pineapple Cranberry Sauce Rice, Dry Yes Beans, Dry Yes Fresh Vegetables (If available) Carrots Onions Squash Tomatoes Potatoes Celery Lettuce Spinach Cabbage Broccoli Fresh Fruit (if available) Apples Oranges Cherries Pears Peaches Bananas Grapes Strawberries Margarine Yes Donuts Yes Bath Soap Small Bar Soap Large Bar Soap Shower Body Soap Dental Care Toothpaste Mouth Wash Dental Floss Toothbrush Hair Care Shampoo Conditioner Body Lotion Yes Shaving Supplies Shaving Gel Multi-pack razors Single razor Buns Pick One Hamburger Hotdog Eggs Yes Milk 1/2 Gallon Gallon Bread Bread options are based on availability Bakery Style Bread (Artisan) Soft Bread Whole Wheat Hotdogs Yes Meat Pick one option Chicken Breast Ground Beef Comments Thank you!