Please Note: An asterisk (*) designates a required field. Date of Distribution* MM slash DD slash YYYY Vendor*Select Vendor...ARC - American Red CrossCC - Catholic CharitiesFCE - Feeding Children EverywhereFF - Feeding FloridaFS - Farm ShareTSA - The Salvation ArmyCounty*Select County...AlachuaBakerBayBradfordBrevardBrowardCalhounCharlotteCitrusClayCollierColumbiaDadeDeSotoDixieDuvalEscambiaFlaglerFranklinGadsdenGilchristGladesGulfHamiltonHardeeHendryHernandoHighlandsHillsboroughHolmesIndian RiverJacksonJeffersonLafayetteLakeLeeLeonLevyLibertyMadisonManateeMarionMartinMonroeNassauOkaloosaOkeechobeeOrangeOsceolaPalm BeachPascoPinellasPolkPutnamSt. JohnsSt. LucieSanta RosaSarasotaSeminoleSumterSuwanneeTaylorUnionVolusiaWakullaWaltonWashingtonPlease enter unit numbers for the categories below:MealsSnacksFood BoxesWaterSSMBulk - please enter net weight of products delivered:Fresh ProduceOtherCommentsThis field is for validation purposes and should be left unchanged.
