Produce Fruit - fresh: ___ Apples ___ Oranges ___ Pears ___ Grapes ___ Bananas ___ Grapefruit ___ Peaches ___ Lemons ___ Limes ___ Watermelon ___ Cantaloupe Veggies - fresh: ___ Carrots ___ Potatoes ___ Green Beans ___ Tomatoes ___ Celery ___ Peppers ___ Cucumbers ___ Lettuce ___ Onions ___ Broccoli ___ Cauliflower ___ Cabbage ___ Squash ___ Mushrooms ___ Sweet Potatoes ___ Zucchini ___ Other Veggies Meat ___ Beef ___ Ground Beef ___ Chicken: breast - legs - thighs cut up fryer - roaster ___ Bacon ___ Sausage ___ Hot dogs ___ Turkey ___ Ground Turkey ___ Lunch meats ___ Fish ___ Other Seafood ___ Pork: chops - ham -ribs ___ Other Meat Eggs ___ Eggs ___ Egg Substitute Miscellaneous:

Dairy/Cheese ___ Milk ___ Cream ___ Cheese: Mozzarella Cheddar - American - Swiss Parmesan - Cottage - Cream Cheese Other: ___ Yogurt ___ Butter ___ Margarine Drinks Juice: ___ Orange ___ Grape ___ Apple ___ Other Juice: ___ Drink Mixes ___ Coffee ___ Tea ___ Soda ___ Other: Can Goods Veggies - canned: ___ Corn ___ Green Beans ___ Mixed Veggies ___ Carrots ___ Baked Beans ___ Other Beans ___ Other Veggies Fruits - canned: ___ Applesauce ___ Peaches ___ Pears ___ Pineapple ___ Pie Fillings ___ Pumpkin ___ Other Soups - can: ___ tomato ___ chicken noodle ___ vegetable ___ stocks (circle) Beef Chicken Turkey Cream Soups: ___ Chicken ___ Celery ___ Mushroom Meats - can ___ Tuna ___ Chicken ___ Other:

Condiments ___ Ketchup ___ Mustard ___ Mayonnaise ___ Salad Dressing:(circle) Ranch - Italian - French Blue Cheese - Other: ___ Honey ___ Jelly ___ Peanut Butter ___ Pickles ___ Soy Sauce ___ Tatar Sauce ___ Cocktail Sauce ___ Salsa ___ Taco Sauce ___ BBQ Sauce ___ Steak Sauce ___ Vinegar ___ Other: Pasta/Rice Sauces ___ Tomato Sauce ___ Spaghetti Sauce ___ Cheese Sauce ___ Other Sauce: ___ Rice: white - brown seasoned ___ Pasta ___ Other: Snacks ___ Chips ___ Crackers ___ Candy ___ Other: Staples ___ Flour: (circle)white whole wheat - rye - other ___ Corn Meal ___ Sugar ___ Brown Sugar ___ Baking Powder ___ Baking Soda ___ Salt ___ Vanilla Extract ___ Spices: List: ___ Cooking oil ___ Cocoa Powder ___ Chocolate Chips ___ Nuts ___ Other:

Bread Cereal ___ Bread ___ Hot dog buns ___ Burger buns ___ Bagels ___ Taco Shells ___ Tortillas ___ Cereal Dry ___ Oats ___ Cream of Wheat Pet Supplies ___ Food ___ Treats ___ Other Baby ___ Diapers ___ Wet Wipes ___ Medicines: ___ Food ___ Juice ___ Formula ___ Shampoo ___ Baby Oil ___ Baby Powder ___ Other: Household Personal Care ___ Toilet Paper ___ Paper Towels ___ Toothpaste ___ Mouthwash ___ Dental Floss ___ Bar Soap ___ Laundry Soap ___ Other Laundry ___ Bleach ___ Baking Soda ___ White Vinegar ___ Apple Cider Vinegar ___ Other Cleaning ___ Shampoo ___ Deodorant ___ Women's Hygiene ___ Sanitary Pads (circle) Overnight Super Light Days Other: ___ Tampons