*1.What is your first and last name?(Required.)

*2.What is your email address?(Required.)

*3.What is your phone number?(Required.)

*4.What is your street address?(Required.)

*5.What is your postal code?(Required.)

*6.Which FoodCycler model would you like to purchase for your household?(Required.)

FoodCycler FC-30 ($150 + HST)

FoodCycler Maestro ($300 + HST)

*7.I acknowledge that by participating in this pilot program and obtaining a municipally subsidized FoodCycler, I am required to track usage for 12 weeks and complete a brief exit survey about my experience with the program.(Required.)

Yes