SNVB Larder Member Registration

SNVB Larder Member Registration Form

Your Contact Details

First Name *

Last Name *

Address Line 1 *

Address Line 2

Town *

County *

Postcode *

Telephone Number *

Email *

About you

Occupation *

Employment Status *

Are you in receipt of benefits? *

Number of adults in your household (over 17) *

Number of children in your household (under 18) *

Local larder *

Where did you hear about the community larder? *

How will being a member of the Community Larder help you? *

Access to food

Make money go further

Meet new people

Save food from waste

Reduce debt pressure

A healthier diet

Age group *

Ethnicity *

Do you consider anyone in your household to have a physical or mental health disability? *

Is anyone in the household 65 or above? *

To help us understand how best to support our community, can you tell us if you are experiencing any challenges accessing or affording food by selecting one of the options. Your response is confidential and only used in a general way to support funding *

I would consider myself/my household in food crisis

I would consider myself/my household in food hardship

I would not consider myself/my household in food crisis or hardship but finances are very tight

None of the above

A delivery service is reserved for those who are genuinely unable to attend a session in person. Due to very limited capacity, deliveries are only arranged in exceptional circumstances. If you are completely unable to visit and need urgent support, please contact us at [email protected] so we can assess whether an emergency delivery can be arranged.

Consent *

I agree to snvb contacting me to send relevant information about Larder activities and other news and information about snvb projects.

Captcha

If you are human, leave this field blank.