Faith Community Food Delivery Request Form

Thank you for filling out the Faith Community Food Delivery Form. An ICS staff member will contact the person listed in the form soon after the form’s completion. If you have any questions, please contact Tim Kromer at 520-526-9290 or at tkromer@icstucson.org or Jay Deskins at 520-314-3271 or at jdeskins@icstucson.org.

Name of Faith Community*
Number of Families Needing Food*
Please provide an estimate of the total number of families who may need food
Number of Large Families
How many of these families have 5 or more family members?
Address
Address of the Faith Community

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Contact Person*
Who should we contact for questions and to confirm delivery date?
First Last
Contact Person's Phone*
Email
Please provide the best email to contact you
Delivery Contact
Deliveries take place on Fridays between 9am - 11am. Please let us know who will be there to receive the delivery.
Delivery Contact Phone
Are you willing to fill out a tracking log to give back to ICS?
- Yes
- No
Repeat Delivery
Would you like us to deliver more food to your faith community in the future?
- Yes
- No
Phone
This field is for validation purposes and should be left unchanged.