Voucher Form

For referral agency use only.

For three day’s emergency supply of food.

Please ensure that you complete ALL fields before submitting.


Notes for Referral Agencies

Please ensure that your client is in agreement with the following statement before submitting a request for assistance:

I give my consent for Canterbury Food Bank to contact the referral agency to discuss my circumstances, and I give my consent for my data to be held in a database:
• To enable food parcel control and,
• for the production of statistical reports, which I understand, will NOT contain my personal identification details

Up to five Canterbury Food Bank vouchers are normally allowed per household in a 12-month period. If you feel it is necessary to issue more than 5 vouchers please get in touch.

If a client is residing with friends or wider family, these are not classed as dependents and should not be shown on the voucher.



Choose a representative to help you with your food parcel.

× Can I help you with a food parcel?