North Kawartha (Phase 2) - FoodCycler Pilot Program Registration Form

Participants in the FoodCycler program will be selected on a first come first served basis. Registering for the program here does not guarantee your spot in the program. You will be contacted if you are selected to participate. 
 
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 address in the Township of North Kawartha (not PO Box)?(Required.)
5.What is the postal code?(Required.)
6.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.)