New Client Registration

First Name

Last Name

Preferred Name (if different)

Date of birth

Gender (for statistical purposes only)

Marital Status

Address - Street

Unit Number

Province

Postal Code

Housing Type Housing Type

Telephone

Identification File 1 (Front and back)

Maximum upload size: 10.49MB

Identification File 2 (Front and back)

Maximum upload size: 10.49MB

Proof of address

Maximum upload size: 10.49MB

Spoken Language(s)

Ethnicity (For statistical purposes only)

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?

Is anyone in your household currently attending a Post-Secondary College, University, or Institute? Is anyone in your household currently attending a Post-Secondary College, University, or Institute?

What is your primary reason for visiting the Central Okanagan Food Bank?

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

Full Name

Date of Birth

Identification File 1 (Front and back)

Maximum upload size: 10.49MB

Identification File 2 - required for 18+ years (Front and back)

Maximum upload size: 10.49MB

Add Member Remove

Highest education level completed:

Country of Education:

What is your household's primary source of income?

Do you or your household members have any dietary considerations or allergies?

Please attach any relevant medical documents here

Maximum upload size: 10.49MB

As a Member of Food Banks Canada, the Central Okanagan Food Bank stores and shares certain data for the purpose of advocating to reduce food insecurity across Canada. COFB will not share any personal or identifying information with Food Banks Canada, or any other agency.