GJMA – Food Box Distribution Orders

Please fill out the form below to complete your order for the coming distribution on Tuesday.

Name*
First Last
Phone
If you leave your phone number, we will contact you when your order is ready.
Email
Boxes*
Please indicate the total number of boxes you are ordering.
Names for Pick-Up
Please list the names and # of boxes of any individuals included in your order who will be picking up at the distribution. (list them on separate lines if possible)