Boone Campus Food Pantry Request Form

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Boone Campus Food Pantry Request Form

Please use this form to request food from the DMACC Boone Campus Food Pantry. We will make every effort to honor your request. Our Summer 2020 distributions are scheduled for Thursdays 12:00 - 1:30 p.m. If you have a food emergency or need additional assistance, please contact Erin Neumann at eaneumann@dmacc.edu or 515-635-1222. This institution is an equal opportunity provider.

Preferred Contact Method:

First Name:

Last Name:

Email Address:

Phone Number:

Can we text you at this number?

Relationship to DMACC (choose one):

Current Student

Current Employee

Future Student

Future Employee

DMACC Alumni

Friend of DMACC

Do you have a DMACC ID?

DMACC ID#

Number of people in your household

Our standard package of food contains a variety of foods that may include canned fruits, canned vegetables, proteins (canned tuna, canned chicken, peanut butter, beans), rice, cereal, soups, or pasta. From time to time we may also have eggs, dairy products, bread, meat, or fresh produce.

Please select the food package you prefer:

If they are available, do you request any of these items? (Check all that apply)

Bread

Cheese

Eggs

Fresh Produce

Frozen or Refrigerated Meat

Milk

Do you have any food allergies we should be aware of when packing your food request?

Are there any foods you do not want to receive?

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