Request A Casserole

Would a homemade casserole delivered to your door make a difference in your day?

Just apply below, we will contact you and let you know when we can deliver one to you! See the Fact Sheet for complete details.

Fact Sheet

Application

Name

First Name

Last Name

Email

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Please check which size casserole you would like:

8 x 8 | perfect for a single or couple

9 x 13 | great for a family

Tell us in a sentence or two how receiving a HOLY CASSEROLEY could make your life a little better or easier:

Waiver

By submitting this online application, you are accepting the terms of this waiver. My participation in Holy Casseroley is undertaken at my sole risk. I hold harmless Providence Presbyterian Church and all volunteers – cooks, delivery drivers, administrators (e.g., “Covered Persons”) associated with the program. I agree that Covered Persons shall not be responsible for any adverse reactions, side effects, injury, bodily harm or death that results from consumption of the donated food products or any other liability arising thereof.

I ACCEPT

If you prefer, you may download and print out a PDF of the application, complete it and follow the instructions for submitting it.

Would a homemade casserole delivered to your door make a difference in your day?

Application