Meal Order WEN COMMUNITY FOOD SUPPORT MEAL ORDER PICK-UP & DELIVERY REQUEST INSTRUCTIONS: WEN-Fight-Against-COVID-19-Campaign-PROGRAM-STEPS Download 1. Date *2. I am *VulnerableA 1st Responder3. I Am Vulnerable because I (IF NOT CHOOSE N/A IN DROPBOX): *Have An Existing Underlying Medical ConditionsI Am Over 60 years OldI Am PregnantI Am Layed OffOther - *Specify BelowN/A4. I Am A First Responder (Professional or Volunteer Worker) In Which Area (IF NOT CHOOSE N/A IN DROPBOX):: *FirefighterParamedicsLaw EnforcementMilitary PersonnelMental Health Emergency DispatcherEmergency Medical TechnicianOther - *Specify BelowN/A5. If Your Selection For Questions #3 or #4 is OTHER, Please Indicate Which Area Of Emergency You Fall Under *6. This person, hospital, group, etc., can confirm my status (MUST PROVIDE NAME, PHONE, EMAIL for verification) *PLEASE NOTE: What is the name and address of this person, hospital, group, etc., who can confirm my status? You will not qualified if we cannot verify the information you have provided.7. Name of Meal Recipient *First and last name8. Email of Meal Recipient *EmailConfirm Email9. Number (MUST PROVIDE VALID NUMBER) *10. I Want to Order Food From: *5 Sisters Restaurant, Laurel MDJollof Etcetera , Hyattsville MDKof Sports Cafe, Bowie MDZion Kitchen, DCKingsway, Laurel MD11. I Need My Meal Picked Up & Delivered *YesNoWEN makes no pickup & delivery promise. WEN can assist if we find volunteers. Please try to make your transportation arrangement. 12. Briefly Explain What Qualifies You To Have Your Food Picked Up And Delivered To You. *CommentSubmit
