First and Last Name of Applicant

Email address of Applicant

Phone number of Applicant

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 and share my personal 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.

Serving Pickering and Ajax residents since 1990

NEW REGISTRATIONS MUST BE COMPLETED BY APPOINTMENT ONLY.

PLEASE FILL OUT YOUR CONTACT INFORMATION BELOW.

ONCE SUBMITTED, YOU WILL RECIEVE AN EMAIL CONTAINING YOUR APPOINTMENT DAY, TIME AND AN INFORMATION SHEET ON HOW TO PREPARE FOR YOUR REGISTRATION INTERVIEW.