Request A Packing Date Contact Information Fields marked with a star () are required and must be completed in order to submit the form. Name Email Primary Phone Alternate Phone Have you packaged with us before? Yes No Group Information Please enter the organization you represent or give your group a name. Organization | Group Name Street Address City State Zipcode My group can raise $4000 to pack 16,000 meals $5000 to pack 20,000 meals $10,000 to pack 40,000 meals $25,000 to pack 100,000 meals More than $25,000 Group Composition Estimate the number of adults, youth & children who may be participating. Keep in mind that 2 adults are required for every 10 youth (under 18 years old). Adults (ages 18+) Youth (ages 13-17) Children (ages 5-12) Total Group Size Preferred Date & Time Please choose your preferred date as well as an alternate date in case the first is unavailable. Please choose the period of the day which would best suit your group. For other concerns you may have, please note the details of your request in the comment section below and we will do our best. Preferred Date (mm/dd/yyyy) Alternate Date (mm/dd/yyyy) Best Time of Day Morning (9-12am) Afternoon (1-5pm) Evening (5-8pm) Questions or Comments Security Please enter the following word in the space provided. If you're unable to read the letters, use the REFRESH icon to generate a new word. SEND Thank you for sending in a request for a packing date! We appreciate very much your interest in packing food for the hungry and will be in touch with you as quickly as we can to make this event a reality for you and your group. In the meantime, if you have any questions, please call us at 954.793.2487 or email us. A Heart Like His Foundation Please turn on javascript to submit your data. Thank you!