LRCA Food Bank Registration

Download Disclaimer (required)

Fields marked with * are required.

Your name *

First

Last

Your email *

Your date of birth *

What is your address?

Where are you staying?

Postal code

Best phone number

DEPENDENTS (live with you)

First

Last

Dependent 1 - date of birth

Dependent 2

First

Last

Dependent 2 - date of birth

Dependent 3

First

Last

Dependent 3 - date of birth

Dependent 4

First

Last

Dependent 4 - date of birth

Dependent 5

First

Last

Dependent 5 - date of birth

Dependent 6

First

Last

Dependent 6 - date of birth

How did you hear about the LRCA Food Bank?

How long have you lived in Ladysmith?

Are you new to Canada?

If yes, when did you arrive?

Can you get to and from the Food Bank without help?

Are you a post-secondary student?

I have read and understood the information above and by checking this checkbox, I agree that my local Food Bank may collect, use, and disclose my personal information for the purposes mentioned in the PDF disclaimer at the top of this page. I also agree that my personal information be entered into the Food Banks Canada's Link2Feed Client intake software and may be entered into my local Food Bank's CMS. *

Any other questions or comments?

Ladysmith Resources Centre Association

Location:

630 2nd Avenue, Ladysmith, BC
P: 250-245-3079
F: 250-245-3798
Monday – Thursday: 9:00 AM – 4:30 PM
Friday: 9:00 AM – 3:00 PM

Office is closed daily 12 PM- 12:30 PM
Get in touch via email »

Registration no.

896835667 RR 0001

Mailing

P.O. Box 1653

Ladysmith BC, V9G 1B2

LRCA Food Bank Registration

Ladysmith Resources Centre Association

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