Curbside Pick up Food Order Form
Beginning April 1, until further notice Tiger Pantry will have curbside pick up or delivery operations. To be eligible for pick up at this location, you must complete this form by
am the Wednesday before
you plan on picking up your food. This allows us adequate time to prepare your order.
Late orders are not guaranteed to be filled.
Please indicate you have read the above message by checking the box.
Date of Birth (MM/DD/YYYY)
Will someone other than you be picking up your order?
If yes, please provide their name below.
How many adults (over the age of 18) are in your household who are in need of food?
How many children are in your household who are in need of food?
List dietary restrictions/special requests (Ex. Do you have access to a microwave, stove?) Please be as detailed as possible so we can give you the best food for you and your household.
What items would you like to pick up through our curbside service?
Please note that you may receive dry/household goods once a month and produce items weekly.
Monthly food (dry goods/household goods)
Produce items (eggs/bread/fresh produce)
Are you a MU Health Care employee?