Food Pantry

Please take the following survey
Name: 


  1. Do you or your household need a non-perishable food bag for the month of November?
    Yes
    No


  1. If yes, how many people are in your household (including yourself)?
    1
    2-3
    4-5
    6 or more


  1. Do you have any specific life-threatening dietary restrictions we should be aware of?


  1. Any additional comments?






ARC Smart
AZ