DMS Food Pantry

DMS Food Pantry
Request Form

Thank you so much for your interest in the food pantry! We are happy to help and hope that you continue to request food from the DMS Food Pantry in the future!

By completing and signing this form, you may request grocery bags of non-perishable food filled by the DMS Food Pantry. Once the bag is filled, the food will be delivered to the guidance counseling office, where the student or family can pick it up and take it home. We will notify you when the bag has been filled. We recommend that students transport only one bag of food at a time, but you may request additional bags if someone else will be picking up the food.

Please take note of a few important details:
* We are unable to fill requests for specific food items, but we will do our best to avoid giving you food that anyone in your family may be allergic to. All food is nonperishable new sealed items.
* Please have your student pick up the bag within 2 days. If the bag is not picked up, it may be returned to the pantry for others to enjoy.
Thank you!

Please provide us some additional information:
Student Name: ________________________________ Grade: ________
Parent Name: ________________________________
Parent Phone and Email: ________________________________
Number of people in the household: _______________
Any Food Allergies: ____________________________________
Who will pick up the food: _______________________________
Signature: ____________________________________
Date: _________________________

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