New Resident Registration New Resident Registration First Name * Last Name * Preferred Name (if different) Date of birth * Gender (for statistical purposes only) * Marital Status * SingleMarriedCommon-LawDivorcedSeperatedWidowedOther Address - Street * Unit Number Province * AlbertaBritish ColumbiaManitobaNew BrunswickNew Founland and LabradorNova ScotiaOntarioPrince Edward IslandQuebecSaskatchewan Postal Code * Name of Agency/Residence Email * Telephone * Identification File * Drop file here or click to upload (Driver's License, BCID, PHN, Passport, Birth Certificate, etc.) Choose File Maximum file size: 32MB Spoken Language(s) * Ethnicity (For statistical purposes only) * BlackIndigenous (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.)FilipinoWest Asian (e.g. Iranian, Arab, Turkish, etc.)WhitePrefer Not To SayOther Ethnicity (For statistical purposes only) Do you identify as a person with a disability? * YesNoPrefer Not To Say Have you been in Canada less than 10 years? * No, I have lived in Canada for more than 10 yearsYes - please enter Year and Month of Arrival to Canada Have you been in Canada less than 10 years? What is your primary reason for visiting the Central Okanagan Food Bank? * Low hourly wage/delayed wagesNot enough work hoursUnemployed/Recently lost jobSocial Assistance/Benefits too lowCost of Housing (rent, mortgage)Cost of Utilities (hydro, heat, gas, water)Cost of foodRelocation (immigration/moving)Unexpected expenseSickness/Medical ExpensesDebtNatural Disaster (fire/flood)Family break-upInflationOther What is your primary reason for visiting the Central Okanagan Food Bank? Highest education level completed: * Grade 0-8Grade 9-11Grade 12OAC/GED/equivalentPost Secondary (some)Trade Certificate/Professional AccreditationCollege DiplomaUniversity DegreePhDOther Country of Education: * What is your primary source of income? * EmploymentEmployment InsuranceSocial AssistanceDisability Related BenefitsPension IncomeStudent Loans/ScholarshipsCanada Child BenefitNo IncomeOther Do you have any dietary considerations or allergies? Please attach any relevant medical documents here Drop a file here or click to upload Choose File Maximum file size: 32MB 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. Submit If you are human, leave this field blank.
