Wait List

Thank you for your interest in our Love Boxes! We’re excited to let you know that these special boxes will be available as soon as we secure the necessary funding. By completing this form, you’ll be added to our waitlist and will be among the first to receive a Love Box once they’re ready. We appreciate your patience and support!

Love Boxes

Love Boxes are customized to fit you and your family’s need. You select the food and household items you want. Some items are individual, so please fill out the form completely so we can meet each person’s need. Please list a vaild email address or phone number to ensure that your family receives their customized Love Box. Thank You!

Ready for a Love Box?

Name

Email Address

Phone Number

Home Address for delivery

How many family members are in the home?

How many Men/Boys

Boys Ages

Number of Women/Girls

Girls Ages

Name of school who referred you

Do you already receive government food assistance? Do you already receive government food assistance? Yes No

Please choose a box or boxes Please choose a box or boxes Food Box Personal Care Box

You do not qualify for a Love box You do not qualify for a Love box

Food Box: All boxes include rice, pasta, canned vegetables, and canned fruit. Please select additional items and the cuisine you would like.

Personal Care Box: Each family member will receive a personal toothbrush and deodorant. Please choose additional items for the household. Personal Care Box: Each family member will receive a personal toothbrush and deodorant. Please choose additional items for the household. Body Soap Toothpaste Mouthwash Toilet Paper Paper Towels Laundry Detergent Cleaning Supplies Feminine Products

Tacos or Nachos (Please Choose ONE) Tacos or Nachos (Please Choose ONE) Tortilla Chips Hard Taco Shells Soft Taco Shells Hard and Soft Taco Shells

Protein (Choose Up To FOUR) Protein (Choose Up To FOUR) Black Beans Kidney Beans Refried Beans Queso Cheese Dip No Protein

Toppings (Choose Up To FOUR) Toppings (Choose Up To FOUR) Salas Jalapeno Peppers Banana Peppers Canned Corn No Toppings

Seasoning ( Choose Up To THREE) Seasoning ( Choose Up To THREE) Taco Seasoning Packet (2) Salt Black Pepper No Seasoning

Pasta Noodles (Please Choose ONE) Pasta Noodles (Please Choose ONE) Spaghetti Penne Ziti Rigatoni

Pasta Sauce (Please Choose ONE) Pasta Sauce (Please Choose ONE) Tomato Basil Garlic Sauce Alfredo Sauce No Sauce

Protein Protein Parmesan Cheese No Protein

Seasoning (Choose Up To FOUR) Seasoning (Choose Up To FOUR) Garlic Italian Salt Black Pepper No Seasoning

Tuna Casserole or Chili Tuna Casserole or Chili Tuna Casserole (comes with all ingredients) Chili (Come with all ingredients)

Desserts (Please Choose ONE) Desserts (Please Choose ONE) Chocolate Chip Cookies Peanut Butter Cookies Boxed Vanilla Cake Mix with Icing Boxed Chocolate Cake Mix with Icing

Snacks (Please Choose ONE) Snacks (Please Choose ONE) Popcorn Fruit Snacks Cheese Nip Plain Potato Chips BBQ Potato Chips

Breakfast (Please Choose ONE) Breakfast (Please Choose ONE) Granola/Breakfast Bar Cereal Oatmeal Grits Pancake Mix and Syrup

Protein Items (Choose Up To Four) Protein Items (Choose Up To Four) Canned Tuna Vienna Sausage Spam Canned Chicken

Extra Beans (Choose Up To Four) Extra Beans (Choose Up To Four) Black Beans Pinto Beans Kidney Beans

Tampon and Pads (Choose Up To Two) Tampon and Pads (Choose Up To Two) Tampons Pads

Please select the additional items you want.

3 + 5 =