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Loop Resource - I want to get involved!
Food Diversion Program
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Phone Number (cell phone preferred)
*
(Ten digits, no dashes or spaces: 2501231234)
Your answer
Additional Phone Number (Optional)
(Ten digits, no dashes or spaces: 2501231234)
Your answer
Physical Address (Street Address or Legal Land Description)
*
This helps us place you on a map, and we will contact you when store options open within your driving area.
Your answer
Email Address
*
We will not publish your email, or share it. We will contact you at this address to keep you in the loop on our activities in your area!
Your answer
Province (or Country)
*
Choose
BC
Alberta
Saskatchewan
Manitoba
Ontario
Quebec
New Brunswick
Nova Scotia
PEI
Newfoundland & Labrador
Northern Territories (Yukon, NWT, Nunavut)
USA
Other
Nearest Town, or Towns you frequent on a daily or weekly basis: (or City region, if you are near a city) You may identify any area you like, and also include which area is your "favourite" here.
*
Your answer
Animals that you have:
*
Chickens
Pigs
Dogs
Small grazing livestock (sheep goats llamas etc)
Large Grazing Livestock
Other
None - I have a grocery store
Required
Describe your farm: (Optional)
Your answer
How did you hear about us?
Your answer
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