New Client Registration

Last Name

First Name

Preferred Name (if different)

Date of birth

Gender Identity Gender Identity

Marital Status

Address - Street

Unit Number

Province

City

Postal Code

Housing Type Housing Type

Telephone

Photo Identification (Front of ID)

Maximum file size: 10MB

Please note: some individuals have been experiencing issues with uploading files. If you are having trouble, please contact us for help! Email info@cofoodbank.com or call 250-763-7161.

Proof of address (one piece required)

Maximum file size: 10MB

Please note: some individuals have been experiencing issues with uploading files. If you are having trouble, please contact us for help! Email info@cofoodbank.com or call 250-763-7161.

Spoken Language(s)

Do you identify as a person with a disability?

Have you been in Canada less than 10 years? Have you been in Canada less than 10 years?

Are you a Refugee?

Are you currently attending a Post-Secondary College, University, or Institute?

Highest education level completed:

Country of Education:

What is your household's primary source of income? What is your household's primary source of income?

Do any household members have dietary considerations or allergies?

Allergies (Please Specify)Allergies (Please Specify)

Celiac/Gluten-Free

Halal - strict

Halal - chicken okay

Lactose Intolerant

Vegan

Vegetarian

Please attach any relevant medical documents here

Maximum file size: 10MB

Data Collection & Privacy Information: The Central Okanagan Food Bank (COFB) is a member of Food Banks Canada (FBC) and uses Link2Feed software to manage services. To provide you with food assistance and advocate for policy changes, we need to collect and share certain information. By signing/checking this box, you understand and agree that your information is used to determine your eligibility for food, manage programs, and understand community needs. COFB may share your information with Food Banks Canada and Link2Feed. This is done to provide support, conduct research, and eliminate duplication of efforts. When data is used for national advocacy or reports (like HungerCount), it is typically shared in an aggregated, non-identifying form. Your data is stored securely and may be transferred to servers located outside of the province or outside of Canada. You have the right to view your record, correct mistakes, or withdraw your consent at any time by contacting the COFB Privacy Officer. You confirm you have the permission of all adults in your household to share their information.

I have read the above and agree to the collection, use, and disclosure of my personal information as described.

To view our complete Privacy Policy, please visit https://cofoodbank.com/privacy-policy/

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Additional Household Members. Please fill this out for each additional household member (if none, please click "Remove")