APPLICANT'S FIRST AND LAST NAME

APPLICANT'S EMAIL ADDRESS

APPLICANT'S PHONE NUMBER

APPLICANT'S DATE OF BIRTH

APPLICANT'S FULL ADDRESS

CITY/TOWN

POSTAL CODE

PLEASE LIST ALL MEMBERS LIVING IN THE HOUSEHOLD (INCLUDE FULL NAME, RELATIONSHIP TO APPLICANT, DATE OF BIRTH AND INCOME STATUS)

PLEASE LIST ALL SOURCES OF INCOME

Employed full-time
Employed part-time
EI
Ontario Works
ODSP
CPP
Pension
OAS/GIS
Child Support
Child Tax Benefit

HOUSING STATUS

Own
Rent
Subsidized housing
Shared space
Staying with family/friends
Emergency shelter
Group home
Unhoused

PREFERRED STATUS

English
Persian
Spanish
Ukrainian
French

User Agreement

By continuing, I am giving consent to an authorized representative of St. Paul's on-the-Hill Community Food Bank to collect, disclose and use my personal information for the purpose of (i) ensuring the accuracy of the information received on the Application Form is warranted, (ii) allowing St. Paul's on-the-Hill Community Food Bank to assess how my needs may be met and determine whether assistance is warranted, and (iii) allowing St. Paul's on-the-Hill Community Food Bank to use information with other service agencies in order to ascertain, record and determine whether assistance has been or will be obtained. I am confirming all information entered is correct.
We are legally obligated to report any misuse of identification.

User Agreement

Client Confidentiality Agreement

At St. Paul’s on the Hill Community Food Bank, we are committed to treating every client with dignity, respect, and compassion. Your privacy is important to us.

Our Commitment to Confidentiality
- All personal information shared with St. Paul’s on the Hill Community
Food Bank is kept strictly confidential. This includes, but is not limited to: names, addresses, contact information, household details, financial circumstances, and any personal or sensitive information shared while accessing our services.
- Client information will not be shared, discussed, disclosed, or released to anyone outside of the organization without the client’s explicit consent, except where disclosure is required by law.

Use of Client Information
Information is collected solely to provide food bank services, assess needs, improve programs, and meet reporting requirements.
Any reporting completed for funding or operational purposes is done in an anonymous and non-identifying manner.

Respect and Privacy
All staff and volunteers are required to uphold strict confidentiality standards.
Client information will never be discussed in public spaces, shared on social media, or used for any purpose outside of food bank operations.
Every effort is made to ensure conversations and services are provided discreetly and respectfully.

Breach of Confidentiality
Any breach of client confidentiality is taken seriously and will be addressed immediately in accordance with St. Paul’s on the Hill Community Food Bank policies and applicable laws.

By accessing services at St. Paul’s on the Hill Community Food Bank, clients acknowledge and understand this commitment to confidentiality.