member of
  how to help    | about    | events    | about hunger    |     need assistance?    | agencies    | contact us  
July 9th - July 20th, 2012
To register for the Campaign Against Hunger, please complete the form below. When you have finished please click "Sign-Up!" at the bottom of this form.

Click here for a printable form.

* Required Fields
Information
* Company Name:
* CEO / Pres. / Mgr.:
* Street Address:
  P.O. Box & Zip:
* City:
* State:
* Zip:
* Phone #:
* Fax #:
* Company Website:
* Employee Count:
* Coordinator Name:
* Coordinator Phone #:
* Coordinator Email:
* May we promote your participation?

Coordinator Kick-off Breakfast

June 21, 2012 - 8:00am
NET (Nebraska Educational Television) (East Campus)
1800 N 33rd Street Lincoln, NE
 
* Attending Breakfast:

Complete all following fields per location / branch (add more locations below).

Food Drive Details
  Food Drive Date: (change if other than July 11th-22nd)
* Food Drive Address:
* Contact Phone #:
* Contact Email:

Supplies
* Supplies:
  Number of Boxes: #
  Number of Posters:
Large:   #
Small:   #
Check Stuffer:   #
  Barrels:

Please choose how many
barrels you needed.
Total Number Needed:   #
Pick-Up @ Breakfast:  
Pick-Up @ Food Bank:  
To Be Delivered:  
  Supply Delivery Date: i.e. 07/05/12
  Delivery Instructions:

Characters: (200 remaining)

Food Donation at Conclusion of Drive

* We can deliver our donations to the Food Bank:
  Please Pick-up Donations After this Date:
i.e. 07/20/12
  Donation Pick-up Instructions:

Characters: (200 remaining)
 

To add another food drive location click below.
+ Add Food Drive Location (click here)
 





 
4840 Doris Bair Cr. Ste. A  •  Lincoln, NE 68504-1465  •  info@lincolnfoodbank.org
Fact: Programs such as food stamps, affordable housing, and child care and transportation assistance also help low-income workers make ends meet.
site by: Community Connections Inc.