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Rachel's Table Food Bank Partnership Donation Form
Thank you for helping us to alleviate hunger and to reduce waste of our food resources in Western Massachusetts.
Rachel’s Table is a program of the Jewish Federation of Western Massachusetts.
Is this part of the Food Bank Partnership?
Yes
No
Date
MM
/
DD
/
YYYY
Are you a regular Rachel's Table food donor?
Yes
No
Organization
Please select
Aldi's
Amherst College
Big Y Foods, Inc.
Brightwood School
Stop & Shop
Save-A-Lot
Cumberland Farm - Spfld
Cumby Farm - Hadley
Cumby Farm - Amherst
Cumby Farm - Orange
Sandri's
Other
Aldi's Location
Please select
Hadley, 354 Russell St. (Rt. 9)
Westfield, 235 E. Main St.
Big Y Location
Please select
Westfield, 475 East Main Street
Westfield, 1 East Silver Street
Stop & Shop Location
Please select
East Longmeadow, North Main Street
Springfield, Boston Rd.
West Springfield, 935 Riverdale Street
Other Location
Donation Description
Please list items to be donated, including quantity of each item, and number of pounds.
Donation Type (Select all that apply)
Bread and Bakery
Yes
No
Dairy and Eggs
Yes
No
Prepared Foods
Yes
No
Non-perishables
Yes
No
Produce
Yes
No
Meat and Protein
Yes
No
Donation Description
Weight Equivalencies
Heavy produce box = @50 lbs.
Light produce, bread, baked goods = @15 lbs.
Bag of bread, baked goods = @3 to 5 lbs.
Other boxes (not labelled) = @25 to 30 lbs.
Pounds ambient
Pounds refrigerated
Pounds frozen
Special Instructions
Donor Valuation (Optional)
$
Dollars
Is the donation perishable?
Yes
No
Is the meat frozen solid at pick up?
Yes
No
Is the meat frozen solid at delivery?
Yes
No
Is the produce ambient temperature at pickup?
Yes
No
If not ambient, temperature at pickup.
If not ambient, temperature at delivery.
Dairy-Temperature at pickup.
Dairy-Temperature at delivery.
Email receipt to
To be completed by driver or dispatcher
Delivered to
All Nations Church of God
Amherst Survival Center
Bowen Center, The
Care Center, The
Center for Human Dev/Community Assessment Program
Community Survival Center
Companeras Women's Shelter
First Baptist - Amherst
Forum House
FCCMP
Gandara Family Resource
Girls Inc of Holyoke
Gray House, The
Greenwich/Open Pantry Teen Living Program
HAP Housing Wayfinders)
Highland House
Eleanor B. Jenkins Memorial Soup Kitchen
Jewish Family Service
Kate's Kitchen & loreto House
La Voz/Tapestry Health
Loaves and Fishes Soup Kitchen
Longmeadow Adult Center
Lorraine's Soup Kitchen and Pantry
Macedonia Church of God in Christ
Main Street Shelter (Valley Opportunity Council)
Massachusetts Militray Support Foundation
Margaret's Pantry
Martin Luther King Jr. Community Center
Northampton Survival Center
Oasis Food Pantry
Open Pantry Emergency Food Program
Our Hous-Domus
Parish Cupboard
Phoenix House Springfield Center
Project Hope Pantry House of Refuge Church
Ronald McDonald House of Springfield
S.M.A.R.T. Food Pantry
Salvation Army Food Pantry, Greenfield
Salvation Army Food Pantry, Holyoke
Salvation Army Food Pantry, Springfield
Samaritan Inn
Senoirity House
Shiloh Community Service Center
Springfield Housing Authority
Springfield Rescue Mission
Square One
St. Johns Friends' Place
Valley Opportunity Council
Victory Temple
Westfield Food Pantry
Worthington House (Friends of the Homeless
YMCA Greenfield
YMCA Greenfield Camp
Other
Other
If delivered to more than one location, describe:
Dispatcher
Driver
Other Notes
