FO Outreach Monthly Menu Order Form
Date
-
Month
-
Day
Year
Date
Client Name
Phone Number
-
Area Code
Phone Number
Frozen Meat & Eggs (Pick up to 4 Items)
Meat (Pick up to 4 items)
Quantity
Ground Beef
Ground Turkey
Smoked Turkey Sausage
Chicken Tenders
2 Salmon Fillets
1 Dozen Eggs
Total Meat
Total Meats
Entrees and Protein (Pick up to 32 items)
Proteins
Quantity
Canned Sardines (Limit 4)
Canned Salmon (Limit 4)
Jack Mackerel (Limit 4)
Canned Turkey (Limit 4)
Peanut Butter (Limit 4)
Canned Chicken
Canned Tuna
Frozen Entrees
Quantity
Baked Chicken Breast
Thai Peanut Chicken
Ham and Split Pea Soup
Ham, Greens ,and Black Eyed Peas
Honey Baked Ham
Pizza Pasta
Sweet and Sour Meatballs
Vegetarian Lasagna
Vegetarian Lentil Soup
Cheese Tortellini
Total Items 2
Total Frozen Entrees and Protein
Juice (Pick up to 2 items)
Juice (Pick up to 2 items)
Quantity
Frozen Canned Orange Juice
V8 Low Sodium
Welch's Apple Juice Concentrate
Total Items 3
Total Juice
Grocery Staples (Pick up to 16)
Beans and Legumes- Great Source of Protein
Quantity
Dry Lentils
Dry Split Peas
Dry Pinto Beans
Dry Black-Eyed Peas
Dry Great Northern Beans
Canned Garbanzo Beans (Chickpeas)
Canned Black Beans
Canned Red Beans
Grains- Great Source of Protein
Quantity
White Long Grain Rice
Brown Long Grain Rice
Pearl Barley
Penne Rigate Noodles
Elbow Macaroni
Spaghetti Noodles
Whole Wheat Spaghetti Noodles
Corn Tortillas
Egg Noodles
Old Fashioned Oats
Soups, Sauces, and Mixes
Quantity
Chocolate Pudding
Banana Cream Pudding
Canned Chicken Broth
Canned Soup - Cream of Chicken
Canned Soup - Cream of Mushroom
Canned Soup - Tomato
Canned Soup- Chicken Noodle
Jiffy Cornbread (Limit 4)
Pancake Mix (Limit 2)
Canned Pasta Sauce (Limit 4)
Box Macaroni and Cheese (Limit 4)
Cereal (Pick up to 2)
Quantity
Cornflakes
Toasted Oats
Raisin Bran
Total Items 4
Total Grocery Staples
Fruits, Veggies, and Sides (Pick up to 32 Items)
Frozen Sides
Quantity
Mixed Fruit
Cranberry Relish
Cinnamon Apples
Roasted Mixed Vegetables
Green Beans w/ Almonds
Wild Rice w/ Mushrooms
Black Eyed Peas
Canned Fruit Veggies
Quantity
Whole Peeled Tomatoes
Diced Tomatoes and Green Chilis
Corn
Creamed Corn
Carrots
Green Beans
Mixed Vegetables
Beets
Peas
Sauerkraut
Spinach
Allen's Mixed Greens
Applesauce
Sliced Peaches
Pineapple
Fresh Produce
Quantity
2 Potatoes
1 Sweet Potato
1 Onion
1lb Carrots
1 Green Pepper
1 Cucumber
1 Tomato
1 Garlic
2 Apples
2 Oranges
2 Pears
Total Items 5
Total Fruits, Veggies, and Sides
Submit You Order
Check over your order before submitting!
Please make sure your order is correct before hitting submit. No changes can be made after submission!
Submit Your Order
Should be Empty: