Neighborhood Food and Fund Drive Captain Sign-Up Form - Regional Food Bank of Northeastern New York

Please fill out the form below and follow these steps!

Contact Erin Spence at (518) 786-3691 x286 to schedule a time to pick up your bags at the Regional Food Bank between Wednesday, April 12 and Friday, April 21.
Between Friday, April 21 and Thursday, April 27, bags can be distributed to houses and apartments in your specified area.
Pick up the bags on your route on Sunday, April 30 starting at 9:00 a.m.
Deliver the bags to the Regional Food Bank on Sunday, April 30 between 9:30 a.m. and 2:00 p.m.

Captain Name(Required)

First Last

Organization/Company Name (if applicable)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Choose One(Required)

ZIP Code of Bag Distribution Area(Required)

Street Names of Bag Distribution Area(Required)

I will be covering more than one ZIP code(Required)

Yes

Please fill out a new registration form for each zip code and corresponding street name(s).

Number of Bags Needed (please round up to the nearest 10)(Required)