The Ann B. Clark Co-op

Which school are you affiliated with?

Goodwin University

CTRA

RMS

First Name

Last Name

Day and Pick-Up Window

Household Size

How many in your household are under 18?

Are you enrolled in our TEFAP program?

Yes

Does anyone in your household have food allergies?

Yes

Select the drinks you are interested in:

Juice

Hot Cocoa

Tea

Coffee

Are you interested in picking up diapers?

Per our generous donor, diapers may be picked up once per month.

Yes

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?

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