Curbside Registration | The River Food Pantry
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Curbside Registration

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River Curbside Registration

Read before you start this form!

The River does not discriminate based on age, gender, employment status, or any of the other information entered on this page. The information on this form is not shared with any agency or persons outside of The River. If you have any questions, concerns, or issues with the form, please reach out to info@riverfoodpantry.org or call 608-442-8815. If you would rather update your information physically, you can do this when you come for curbside groceries or you can call or email us to set up a time.

Household Information (Required)

Head of Household Name(Required)
Preferred Name
(Optional - if different than your legal name)
Please enter a number from 0 to 15.
Please enter a number from 0 to 15.
Please enter a number from 0 to 15.
Address

Contact Information (Voluntary)

We highly encourage you to share your contact information so that we can communicate important updates, such as food recalls, schedule changes, or closures due to weather. We send these types of emails and text messages very infrequently. We never spam, share, or sell your personal information.

Demographics (Voluntary)

We greatly appreciate any additional household information that you share with us. Demographic details allow The River to qualify for more grant funding so that we can purchase more food and supplies for you, our clients!

Again, we will never share your personal information. We only report totals to funders, such as the total number of households with veterans that we serve. By telling us more about who you are, The River can do more to improve our programs so that we can better meet your needs!
Primary Language

Household Ethnicities

Please select 1 category per household member. If someone is more than 1 race or ethnicity, please enter them under "Number of People who are Multi-Ethnic in Household" instead of within each specific category.
2 or more races or ethnicities
Gender
Dietary Preferences
(other allergies, restrictions, etc.)
Acknowledgement(Required)
Acknowledgement(Required)
How did you hear about The River Food Pantry?

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