POP-UP Food Market pre-ordering form-

FOOD & OTHER ESSENTIAL ITEMS

 Since 2020 to-date, in a partnership approach model, based at Living and Learning Pakenham, AfriAus iLEAC has been distributing culturally appropriate food relief packages called ‘Luvpacks’, and other basic needs to 470 Victorian African and other Culturally and Linguistically Diverse (CALD) single mothers, mothers with large families, low income earners, unemployed, under-employed women, refugees and asylum seekers. At this stage, AfriAus iLEAC distributes the ‘Luvpacks’ to target African Victorians and other CALD families, homeless people and asylum seekers, facing financial hardship.

This form will only be used by authorised members of the LUVPACKS partnership and for the purpose as outlined below.

PURPOSE

This food & other items pre-order form is used to collect and document beneficiary information of impacted Victorians of culturally and linguistically diverse backgrounds for the sole purpose of the effective delivery and management of AfriAus iLEAC and its partners’ (LUVPACKS) project proudly supported by the Victoria Government through the CALD Communities Taskforce – Pop-up Food Markets  Program.

Please select the food/items you need:

Frozen food- Please select below:

Children's snacks- Please select below (tbc, if available ):

Do you have any disability?

Any dietary requirements?

Are you in quarantine due to travel or infection of the virus?

How did you hear about us:

The collected information will be used for the sole purpose of delivering and managing the CALD Communities Taskforce – Pop-Up Food Markets Program. Hence, I a) Have read the information in this form/The information has been read to me and I understand it. b) Understand this information remains valid for the use of the specified Activity. c) Consent to LUVPACKS Partnership to disclosing my personal information to the Sponsor as necessary for purposes of COVID-19 Response.

Checklist

14 + 15 =

Get In Touch

10 + 12 =

6B henry St, Pakenham, VIC 3810

Phone: 0415 964 113

Email: [email protected]