F2 - Apply for registration as a Sevenoaks Larder client
In registering with us, we will assume that you are happy for us to share your details with any volunteers who will deliver to you on our behalf. These details will be deleted as soon as you are no longer registered with us.
Email address *
Full Name - first name & surname *
Address *
Contact number *
Email address *
Number of adults in household *
Number of children in household *
Do you receive, or have you applied for, any government benefits? *
If yes above, which benefits do you receive/have you applied for? (If none, just put N/A) *
If you are not in receipt of any means tested benefits (or waiting to hear about benefits), please tell us your usual household income per month (after tax) *
Please give details of any other food support that you receive (if none , just put N/A). We are unable to accept applications from those using other food support services. *
If you are able to visit the Larder, when would be your best time to do that? *
9.00 - 10.30am
10.30am - 12pm
12 - 2.00pm
2.00 - 4.00pm
None of these - I will need a delivery
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
If you have indicated that you are unable to get to the Larder yourself at any time, please give us a brief explanation as to why that is *
Sex of Child 1 in household *
Age of Child 1 in household
Sex of Child 2 in household *
Age of Child 2 in household
Sex of Child 3 in household *
Age of Child 3 in household
Sex of Child 4 in household *
Age of Child 4 in household
Sex of Child 5 in household *
Age of Child 5 in household
Does anyone in the family have any allergies that you would like us to note? *
Does anyone in the family have any specific dietary requirements that you would like us to note? *
Does anyone in the family have any other health/mobility issues that you would like us to note? *
Anything else you would like us to know? *
A copy of your responses will be emailed to the address you provided.
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