Do you identify with any of the below? (Check all that apply)
What campus do you attend?
Have you applied for the Compassionate Bursary within the SA?
Do you currently receive food from Harvest Manitoba?
Are you a RRCSA Food Bank user?
Do you have any food allergies?
Do you have any dietary needs?
Details for pickup will be provided with hamper approvals.
Collection, Use and Disclosure of Student Information
The information collected on this form will be used for purposes that are consistent with activities necessary to the operation of the RRCSA Christmas Holiday Hamper Program and in compliance with the provisions of the Manitoba - Personal Information Protection Act (PIPA).
Declaration of Applicant
By submitting this form I certify that:
- I am the person named above.
- All information provided on this application is complete, accurate, and truthful to the best of my knowledge.
- Any information disclosed in this application is subject to audit and you may be asked to provide proof of any items listed in the application.
- I am consenting that the RRCSA may use any comments I make in my thank you note anonymously to promote the Christmas Holiday Hamper program.
Declaration of Applicant.