Which application form will you be filling out?
*
Family Application
Senior's Application
Senior's Application Form
Program Prerequisites:
55 years and older
Living on Salt Spring Island
Lower income
Family Application
Program Prerequisites:
Pregnant and or have children under 18
Living on Salt Spring Island
Lower income with need of food assistance
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Join our mailing list and stay in the loop!
*
Yes add me to your mailing list.
No thank you.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of individuals in family household
*
Please enter a number between 1 and 20
Number of adults (18yrs+)
*
Number of teenagers (13-17yrs)
Leave blank if none
Number of children (6-12yrs)
Leave blank if none
Number of infants (0-5yrs)
Leave blank if none
Are you or someone in the family pregnant?
*
Yes
No
Have you participated in the Farmer's Market Nutrition Coupon Program (FMNCP) in the past?
*
Yes
No
Are you or someone in your household a person of indigenous/Inuit heritage?
Yes
No
Are you able to attend most Tuesday Markets in Centennial Park between 1:30pm-5:30pm?
*
Yes
No
How did you hear about the FMNCP application process?
*
Harvest Program Website
Community Service
Newspaper/Magazine
Social Media
Newsletter
From a friend
Are there any Food Skills you would like to learn through a workshop?
The Community Services Harvest Program runs periodic workshops for our community members. Please use this space to let us know what kind of food preparation or cooking skills you'd be interested in learning.
Please feel free to add any other additional information that explains your need to participate in this program.
This field is optional but any information you share can help us improve the program to better serve you and the community.
I agree to be a part of the BC Farmers' Market Nutrition Coupon Program. I understand that the program provides fresh, local food for lower income families who would otherwise struggle to afford shopping at local markets. I understand that these coupons are for my family's or my own personal use.
Send Application
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