Food Drive Registration
Name
*
First Name
Last Name
Group, Corporation or Organization Name
*
Job Title
*
E-mail
*
Telephone Number
*
-
Area Code
Phone Number
Address for acknowledgement
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Food Drive Information
Food Drive Begin Date
*
-
Month
-
Day
Year
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Food Drive End Date
*
-
Month
-
Day
Year
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Our food drive goal in pounds is: *Each item weighs approximately 1 pound*
*
Our organization will be raising financial contributions for Island Harvest
*
Yes
No
Our organization is interested participating in a Virtual Food Drive for Island Harvest
*
Yes
No
Maybe - Please send us information
Our organization is interested in volunteering at Island Harvest
*
Yes
No
Maybe - Please send us information
We will need a Food Drive Box (1'x1'x3') (available for pick-up in Melville or Uniondale)
*
Yes
No
We will be delivering our collected food to:
*
Uniondale
Melville
Please share any additional information or details about your food drive
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