Confidential Application Form
GFW-FB is currently only accepting applications for within the Greater Toronto Area.

GFreeWifey Foodbank' primary mission is to provide access to safe food. I work with local communities and businesses to advocate, educate and raise awareness that means inconsistently I have safe food to share with people in the community who have demonstrated limited access to safe food. If you would like to be on the distribution list complete this confidential brief application to set up a telephone interview.

*If you require access to safe gluten-free food and are not sure what you can eat you should contact you doctor, dietician or medical professional.

**You can contact the Canadian Celiac Association to learn more about celiac disease and the gluten-free diet at www.celiac.ca

***Any food or support provided by GFW-Foodbank is provided in good-faith and it is the recipients responsibility to do due diligence and ensure what they consume is safe for their individual dietary needs and restrictions.
Email address *
Full Name *
Your answer
Date of Birth *
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Street Address *
Your answer
City *
Your answer
Postal Code *
Your answer
Are you a Canadian Resident *
Occupation *
Your answer
Telephone *
Your answer
What kind of support are you seeking? *
Your answer
Current Monthly Net Income *
Your answer
How many dependants to you have under the age of 18 *
Your answer
Are you currently receiving any community support *
Supports you have received within the last 12 months - Please list which organizations *
Your answer
Why do you require a gluten-free diet *
Any other food allergies or intolerances for your self or dependants *
Your answer
how many people in your house require a gluten-free diet. *
Your answer
Have you contacted your local food bank *
Were the able to provide safe-food *
What is your biggest struggle accessing safe food? *
Your answer
How many times per day do you eat *
how many times a week do you skip a meal because you don't have food or have to ration
Where do you get your food from
Which grocery stores do you shop at most regularly
What other information do we need to know. *
Your answer
Do you have your own transportation. *
Do you have a freezer for frozen foods *
Are you interested in volunteering opportunities *
Looking for suggestions how to better serve the community and people who require support
Your answer
When is the best time to reach you for a short confidential telephone interview. *
Time
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