New Client Registration New Client Registration First Name * Last Name * Preferred Name (if different) Date of birth * Gender (for statistical purposes only) * Marital Status * Single Married Common-Law Divorced Seperated Widowed Other Address - Street * Unit Number Province * Alberta British Columbia Manitoba New Brunswick New Founland and Labrador Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Postal Code * Housing Type * Band Owned Emergency Shelter On The Street Own Home Private Rental Rooming House Social Rental Housing Group Home/Youth Shelter With Family/Friends Other Housing Type Email * Telephone * Identification File 1 (Front and back) * Drop file here or click to upload (Driver's License, BCID, PHN, Passport, Birth Certificate, etc.) Choose File Maximum upload size: 10.49MB Identification File 2 (Front and back) * Drop file here or click to upload (Driver's License, BCID, PHN, Passport, Birth Certificate, etc.) Choose File Maximum upload size: 10.49MB Proof of address * Drop a proof of address file here or click to upload (Driver's License, Rent Receipt, Utility bill, tax receipt, etc.) Choose File Maximum upload size: 10.49MB Spoken Language(s) * Ethnicity (For statistical purposes only) * Black Indigenous (First Nations, Inuit, Metis) Central Asian (e.g. Afghan, Uyghur, Turkic, Tibetan, etc.) East Asian (e.g. Chinese, Japanese, Mongolian, Korean, Taiwanese, etc.) Latin American (e.g. Mexican, Cuban, Haitian, Venezuelan, etc.) South Asian (e.g. Pakistani, Indian, Sri Lankan, etc.) Southeast Asian (e.g. Vietnamese, Cambodian, Laotian, Thai, etc.) Filipino West Asian (e.g. Iranian, Arab, Turkish, etc.) White Prefer Not To Say Other Ethnicity (For statistical purposes only) Do you identify as a person with a disability? * Yes No Prefer Not To Say Have you been in Canada less than 10 years? * No, I have lived in Canada for more than 10 years Yes - please enter Year and Month of Arrival to Canada Have you been in Canada less than 10 years? Is anyone in your household currently attending a Post-Secondary College, University, or Institute? * Yes - Please enter their name No 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? * Low hourly wage/delayed wages Not enough work hours Unemployed/Recently lost job Social Assistance/Benefits too low Cost of Housing (rent, mortgage) Cost of Utilities (hydro, heat, gas, water) Cost of food Relocation (immigration/moving) Unexpected expense Sickness/Medical Expenses Debt Natural Disaster (fire/flood) Family break-up Other 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) Drop file here or click to upload (Driver's License, BCID, PHN, Passport, Birth Certificate, etc.) Choose File Maximum upload size: 10.49MB Identification File 2 - required for 18+ years (Front and back) Drop file here or click to upload. Choose File Maximum upload size: 10.49MB Add Member Remove Highest education level completed: * Grade 0-8 Grade 9-11 Grade 12 OAC/GED/equivalent Post Secondary (some) Trade Certificate/Professional Accreditation College Diploma University Degree PhD Other Country of Education: * What is your household's primary source of income? * Employment Employment Insurance Social Assistance Disability Related Benefits Pension Income Student Loans/Scholarships Canada Child Benefit No Income Other Do you or your household members have any dietary considerations or allergies? Please attach any relevant medical documents here Drop a file here or click to upload Choose File 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. * I agree to having my information collected and shared anonymously with Food Banks Canada to advocate for programs and policy recommendations. If you are human, leave this field blank. Submit