Pick Up at Food Bank AS Food Bank Order Form Hello Foodbankers! Welcome to our online order system. If you haven’t already, please make sure to re-register for the AS Food Bank (link is located in the form below.) Pickups at the AS Food Bank can be done every day we are open (MONDAY, WEDNESDAY, THURSDAY 10am – 5pm and FRIDAY 10am-3pm) in 10-min slots! Please pick up at your scheduled time. The timeframe is 10:00 am to 5:00 pm. Please pick it up at your scheduled time. These will be pre-packaged bags Make sure to pick up your order, or it may result in not being able to use this order form in the future. YOU ARE ALLOWED TO PLACE ONE ORDER A DAY! APPOINTMENTS NEED A 24-HOUR ADVANCE NOTICE! Contact us with any questions Monday – Friday: 805-893-3427 or email as-orderpickup@ucsb.edu I acknowledge that I will only utilize the order pick up program once per day and that failure to pick up my order more than twice will result in not being able to use this resource. You may contact us with any concerns over your order at: 805-893-3427(Required) I acknowledge these standards Name(Required) First Last 6-7 Alphanumeric Perm Number found on Access Card(Required) UCSB Email Address(Required) Phone number Best contact phone number, in case there are any issues with your bag.How many people are you feeding today?(Required)Are you feeding any minor dependents?(Required) Yes No List all minor dependents age, if any:I am a UCSB Student(Required) Yes No Do you authorize someone else to pick up your bag? Yes No Please state the name below: What is your Housing Situation? Hotel Stay Car Living Houseless Staying with Friends/Couchsurfing: Transitional Housing University Housing Family Housing Rental apartment/home Have you re-registered for the Food Bank since July 1st?(Required) Yes No Visit https://foodbank.as.ucsb.edu/register-today/ After finishing, come back to this tab to complete your order.Now it’s time to select your bag! Please only select a single bag option that best describes your situation. Thank you! 🙂 Select bag type(Required) General Distribution Kitchenless (for students with no/limited access to a kitchen) Family (for students feeding 3+ individuals) Produce only Toiletries only Would you like produce?(Required) Yes No This includes a mix of fruits and vegetables. We are unable to take returns on these items.Any allergies or special requests? We will accommodate as best as possible.Select any items that you need! Toothbrush Toothpaste Toilet Paper Laundry Pods Soap Bar Diapers (comment size below) Condoms Lotion Shampoo and Condotioner Mouthwash Razor Shave cream Sunscreen Emergency Contraceptive (My Choiceâ„¢) HiddenAre you in need of a can opener? Yes No ONLY CHECK YES, if you are currently participating in the hotel program or experiencing houselessness. Please add any comments or notes here.How did you hear about our Order-Pick Up service?(Required) Instagram Website The Food Bank @ Ucen Students/Peers Other UCSB campus organizations AS Food Bank Pickup(Required) Δ