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.
* Required
Email address
*
Your email
Full Name - first name & surname
*
Your answer
Address
*
Your answer
Contact number
*
Your answer
Email address
*
Your answer
Number of adults in household
*
1
2
3
4
5
6
Number of children in household
*
0
1
2
3
4
5
Do you receive, or have you applied for, any government benefits?
*
Yes
No
If yes above, which benefits do you receive/have you applied for? (If none, just put N/A)
*
Your answer
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)
*
Your answer
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.
*
Your answer
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
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
*
Your answer
Sex of Child 1 in household
*
Girl
Boy
N/A / Other/Would rather not say
Age of Child 1 in household
Choose
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Sex of Child 2 in household
*
Girl
Boy
N/A / Other/would rather not say
Age of Child 2 in household
Choose
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Sex of Child 3 in household
*
Girl
Boy
N/A / Other/would rather not say
Age of Child 3 in household
Choose
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Sex of Child 4 in household
*
Girl
Boy
N/A / Other/would rather not say
Age of Child 4 in household
Choose
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Sex of Child 5 in household
*
Girl
Boy
N/A / Other/would rather not say
Age of Child 5 in household
Choose
Under 1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Does anyone in the family have any allergies that you would like us to note?
*
Your answer
Does anyone in the family have any specific dietary requirements that you would like us to note?
*
Your answer
Does anyone in the family have any other health/mobility issues that you would like us to note?
*
Your answer
Anything else you would like us to know?
*
Your answer
A copy of your responses will be emailed to the address you provided.
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