The Ann B. Clark Co-op
Which school are you affiliated with?
Goodwin University
CTRA
RMS
First Name
Last Name
Email
Day and Pick-Up Window
Select a Day and Pick-Up Window
Wednesday 11 a.m.-1 p.m.
Wednesday 1-3 p.m.
Thursday 11 a.m.-1 p.m.
Thursday 1-3 p.m.
Household Size
Select Household Size
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1
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5
6
7
8
9
10
How many in your household are under 18?
Select household members under 18
0
1
2
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5
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8
Are you enrolled in our TEFAP program?
Yes
No
Does anyone in your household have food allergies?
Yes
No
Describe allergies
Select the food you are interested in:
Apple Sauce
Beans (Peas)
Beans (Kidney)
Beans (Black)
Canned Carrots
Canned Chicken
Cereal
Chili
Corn
Fruit Cocktail
Jelly
Mac and Cheese
Mixed Veggies
Oatmeal
Pancake Mix (if available)
Pancake Syrup
Pasta (Macaroni)
Pasta (Spaghetti)
Pasta (Ziti)
Pasta Sauce
Peanut Butter
Rice (Brown)
Rice (White)
Soup
Stuffing
Tuna
Select the drinks you are interested in:
Juice
Hot Cocoa
Tea
Coffee
Comments about your order or add-ons to your order?
TEFAP Products you would like to pick up today
What other items you would like to see at the co-op in the future?
If you are human leave this field blank
