Pick Up at Office of Black Student Development Food Bank Order Form – OBSD 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 Office of Black Student Development can be done on Wednesdays and Thursdays in 10-min slots! The timeframe is 1:00 pm to 3:00 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) 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! 🙂 Pre-packaged Bags(Required) General Distribution Kitchenless bag (for students with NO access to a kitchen, i.e. houseless or in a hotel program) Family bag (for students needing food for 3 or more individuals) Produce and Snack only bag Any allergies or special requests? We will accommodate as best as possible.Would you like produce?(Required) Yes No This includes a mix of fruits and vegetables. We can not take returns on these items.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 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? Instagram Website The Food Bank @ Ucen Students/Peers Other UCSB campus organizations Food Pickup – Office of Black Student Development(Required) Δ