EmailMeForm
NEW Rachel's Table Food 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.
if this donation is part of the partnership with teh Western Mass Food Bank, please use the donation form for that program.
Is this part of the Food Bank partnership?
Yes
No
Do not use this form for Western Mass Food Bank Donations.
Please use the dedicated Food Bank Partnership form to enter food donations for this program.
Date
MM
/
DD
/
YYYY
Is the Store/Restaurant/Other Donor a regular Rachel's Table food donor?
Yes
No
Organization
Please select
Agri-Mark, Inc. Central Lab
Alex's Bagel Shop
Atkins Farms Country Market
Atlas Farm Store
BJ's Warehouse Club
Benson's
Big Y Foods, Inc.
Bimbo Bakery
C & S Wholesale Grocers
Carrabba's Italian Grill
Chez Josef
Chicopee Provisions
Cold Harbor Seafood & Market
Comfort Bagels
Cooley Dickinson Hospital
Crestview Country Club
Cumberland Farms - Orange
Deals and Steals
Delaney Market, Longmeadow
Delaney Market, Westfield
Delaney Market, Wilbraham
Dollar Tree Logistics
Donut Dip
The Farm Table
The Federal
Forest Park Farmers Market
Glenmeadow
Great Harvest
Greater Springfield Senior Services
Inter Produce
J. Polep
JGS Lifecare
Jozev Food Products
Kentucky Fried Chicken KFC
Lattitudes
Longhorn Steakhouse
Longmeadow Farmers Market
Longmeadow High School
Longmeadow Public Shools
Massachusetts Military Support Foundation
Meadowbrook Farm
Mercy Hospital
MGM Casino
Olive Garden Restaurant
Outback Steakhouse
Panera Bread
Peppa's Pizzeria
Pizza Hut/Taco Bell
Pride Station
Rachel's Table office
Rise Above
Sandri - Orange
Shriners Hospital
Springfield College Dining Services
Starbucks Coffee
STCC Dining Services
Stop & Shop
Tandem Bagels
Twin Hills Country Club
Veritas Prep Charter School
Westfield Farmers Market
Westfield State University
Big Y Location
Please select
Longmeadow, 679 Bliss Road
Ludlow, 445 Center Street
Springfield, 300 Cooley Street
West Springfield, 503 Memorial Avenue
Westfield, 475 East Main Street
Westfield, 1 East Silver Street
Inter Produce Location
Please Select
Springfield, 679 White St.
Ludlow, 4 White St.
KFC Location
Please select
Chicopee, 1307 Memorial Drive
Holyoke, 2241 Northampton Street
West Springfield, 931 Riverdale Street
Olive Garden Location
Please select
Springfield, 1380 Boston Road
West Springfield, 919 Riverdale Street
Panera Bread Location
Please select
Chicopee, 601 Memorial Drive
East Longmeadow, 450 N. Main Street
Enfield, 90 Elm Street
West Springfield, 935 Riverdale Street
Pizza Hut/Taco Bell Location
Please select
Chicopee, 1471 Memorial Drive
Springfield, 655 Liberty Street
Springfield, 456 Sumner Ave.
West Springfield, 298 Memorial Ave.
Pride Location
Please select
Belchertown, 165 State St.
Chicopee, 27 Montgomery
East Longmeadow, 13 N Main
East Longmeadow, 618 N Main
Easthampton, 60 Union St.
Granby, 122 Rainbow Rd.
Hadley, 25 Russell St.
Hadley, 445 Russell St.
Longmeadow, 1730 Longmeadow St.
Ludlow, 478 Center St.
Northampton, 375 King St.
Southwick, 198 College Highway
Springfield, 77 West St.
Springfield, 1225 Parker Street
Springfield, 1110 Wilbraham Rd.
West Springfield, 757 Riverdale Street
West Springfield, 1247 Riverdale Street
Westfield, 234 East Main Street
Starbucks Location
Please select
East Longmeadow, 42 North Main Street
Holyoke, 40 Holyoke St.
Holyoke, 50 Holyoke St. (in Mall)
Longmeadow, 708 Bliss Rd
Springfield, 1089 E. Columbus Ave
W. Springfield, 1067 Riverdale St
Stop & Shop Location
Please select
East Longmeadow, North Main Street
Holyoke, 28 Lincoln Street
Holyoke, 2265 Northampton Street
Tandem Bagels Location
Tandem Bagels Location
Easthampton, 9 Railroad St
Florence, 1 N. Main St.
Northampton, 306 King St.
Food Donor Contact Name
First
Last
Food Donor
Address Line 1
Address Line 2
City
State
Zip Code
Phone
###
-
###
-
####
Fax
###
-
###
-
####
Email
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 (please provide a brief description of the donation)
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
Special Instructions
Donor Valuation (Only fill in if food donor asks for receipt)
$
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
Dairy-Temperature at pickup.
Dairy-Temperature at delivery.
Is pick up location the same as donor address?
Yes
No
Address for Pick Up (If different from above.)
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Email receipt to (Only fill in if food donor provides an email address)
To be completed by driver or dispatcher
Delivered to
All Nations Church of God
Amherst Survival Center
Behavioral Health Network
Bowen Center, The
Brick House
Care Center, The
Center for Human Dev/Community Assessment Program
Center for Self Reliance Food Pantries
Christina's House
Community Survival Center
Companeras Women's Shelter
Dream Center
Easthampton Community Center
Educare, Springfield
Franklin County Community Meals Program (FCCMP)
Gandara
Girls Inc of Holyoke
Gray House, The
Greenwich/Open Pantry Teen Living Program
HAP Housing (Wayfinders)
High St. Adult Medicine
Highland House
Home City
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)
Manna Soup Kitchen
Massachusetts Military Support Foundation
Margaret's Pantry
Martin Luther King Jr. Community Center
Northampton Survival Center
Oasis Food Pantry
Open Pantry Emergency Food Program
Our Community Food Pantry
Our House-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
Salvation Army Rehab, Liberty St
Samaritan Inn
Seniority House
Shiloh Community Service Center
Springfield Housing Authority
Springfield Rescue Mission
Square One
St. Johns Friends' Place
Stone Soup
Tapestry Health-Harm Reduction, Greenfield
USO
Valley Opportunity Council
Worthington House (Friends of the Homeless)
YMCA Greenfield
YMCA Greenfield Camp
Delivered to Other:
If delivered to more than one location, describe:
Source of Donation
Regular Pick Up
Call In (Requested Pick Up)
Gleaning
Meadowbrook Farm
Farmers' Market Longmeadow
Farmers' Market Forest Park
Farmers' Market Westfield
Other (Please describe)
Other Source
Dispatcher
Driver
Other Notes (anything you think Rachel's Table should know about this donation)
Web Site