Multicultural Family Food Program Registration
Register to join the free 6-month cooking and nutrition program for multicultural families.
Participant Details
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Suburb
*
Household Information
How many people live in your household?
*
Please Select
1
2–3
4–5
6+
Do you have children in your household?
*
Yes
No
How many children?
Background
What is your cultural background?
Please Select
African
Asian
Caribbean
European
Latin American
Middle Eastern
Indigenous
Mixed heritage
Other
What language do you mainly speak at home?
Food & Cooking Needs
What challenges do you face with food or cooking?
Food is too expensive
I don’t know where to buy affordable food
I don’t have enough time to cook
I don’t feel confident cooking
I don’t have the right cooking equipment
I want to learn more healthy recipes
Other
What would you like to learn from this program?
Participation
Are you able to attend monthly workshops (once per month)?
*
Yes
No
Preferred time for sessions
*
Morning
Afternoon
Evening
Consent
Do you consent to participating in the program?
*
Yes
No
Do you consent to photos being taken during sessions for reporting and promotion?
Yes
No
Submit
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