Food Bank Registration - The Salvation Army Church in Oshawa

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Plan a Visit
Community Services
Food Bank
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Food Bank Registration

Registration is required once, for all first time users. If you have used our Food Bank in the past six months you do not need to register again.

Please complete all details to the best of your ability

Full Name

First

Last

Legal First Name *

First Name as on Government ID

Legal Last Name *

Last Name as on Government ID

Your Date of Birth *

Confirm Your Date of Birth

Email Address *

Email

Confirm Email

Mobile Phone Number *

Gender *

Where do you live? PLEASE NOTE: We are only able to provide assistance to residents of Oshawa & Port Perry. *

At this time we're only able to provide assistance for those living in Oshawa and Port Perry. Based on where you live we are unable to provide assistance. Please contact your local community food bank.

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Details for registration

Are You a Student? *

Please choose all that apply to you *

Canadian Citizen
Refugee
Disability
College/University Student
Permanent Resident
Other

Marital Status

Married
Common Law
Separated
Divorced
Widowed
Not Married

Housing Type *

Rent
Own
Social Housing
With family / friend
Shelter
Street

Are you new to Canada? (less than 10 years) *

Yes
No

When did you arrive in Canada *

Monthly Income from all sources *

Number of people OTHER THAN YOU in household

Selected Value: 0

Move slider to show number of people OTHER THAN YOURSELF living in household.

What country did you enter Canada from?

Monthly Rent *

Person 1 *

Person 2 *

Person 3 *

Person 4 *

Person 5 *

Person 6 *

Person 7 *

Person 8 *

Person 9 *

Person 1 Date of Birth *

Person 2 Date of Birth *

Person 3 Date of Birth *

Person 4 Date of Birth *

Person 5 Date of Birth *

Person 6 Date of Birth *

Person 7 Date of Birth *

Person 8 Date of Birth *

Person 9 Date of Birth *

Person 1 Relationship

Person 2 Relationship *

Person 3 Relationship *

Person 4 Relationship *

Person 5 Relationship *

Person 6 Relationship *

Person 7 Relationship *

Person 8 Relationship *

Person 9 Relationship *

Person 1 Gender *

Person 2 Gender *

Person 3 Gender *

Person 4 Gender *

Person 5 Gender *

Person 6 Gender *

Person 7 Gender *

Person 8 Gender *

Person 9 Gender *

Our Privacy Policy has been updated
Click to read and review complete Privacy Policy

Click to confirm consent to privacy policy *

I agree to the updated Privacy Policy & Give Consent

information is complete and accurate *

Yes

I live in Oshawa or Port Perry and have completed this form with complete and accurate information. I give permission for text/phone/email communications with The Salvation Army Oshawa for follow-up as required.

Signed - (enter your name) *

Electronic Sugnature

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