STUDENT FOOD BANK APPLICATION
Concordia University of Edmonton’s Food Bank is coordinated through the Student Life and Learning Office and
the information provided will be kept confidential. Statistical information is collected for information purposes
only and will have no determination in the approval of the application.
Signature of applicant *if submitting online you will be required to sign when you pick
up the hamper
Please submit completed application form to firstname.lastname@example.org
Online submissions will receive a response within 48 hours.
FOR OFFICE USE ONLY:
APPROVAL REMAINS IN PLACE UNTIL: DATE
REASON FOR DECLINE:
NAME OF CUE EMPLOYEE:
SIGNATURE OF CUE EMPLOYEE: DATE