Form Centre

2. Freedom of Information and Privacy
   Collection of Personal Information Collection of Personal Information The personal information you provide to the Town of Banff will be used for the purpose of coordinating resources for those affected by the COVID-19 Pandemic. Your personal information is collected under the authority of Section 40 of the Freedom of Information and Protection of Privacy (FOIP) Act. The Town of Banff might be required to share this information with local agencies related to supporting the community for the specific purpose for which this was collected. Questions regarding this collection of personal information can be directed to the Municipal Clerk 403.762.1209
6. Purpose
   As a part of the Town of Banff’s emergency response efforts to COVID-19, we are conducting a community inventory survey to assess needs and opportunities to support. We are seeking information that will help us best support the community at this time. We have a few brief questions for you, and thank you in advance for your time. Please direct any questions to resource.help@banff.ca.
10. Name of Your Business
    Please list the operating name of your business
12. First Name
13. Last Name
15. Phone Number
16. Email Address
20. Organization Type
    -- Select One --Alcohol or Cannabis sales (take home)Food and Beverage Outlet (primary operation)Hotel or Guest Accommodation (primary occupation, may include food and Beverage as a secondary operation)Medical, Dental or PharmacyPersonal Services (Health and Wellness)Professional Services (cleaning, electrical, accounting etc)Retail - Clothing or EquipmentRetail - GroceriesRetail - Jewelry, Souvenir, GemstonesTourism RelatedOther

    Please select the answer which best describes your business model
22. Other:
    If you listed other, please describe.
24. Operation Status
    -- Select One --Completely OpenCompletely ClosedPartially Open

    Please list if your business is open, closed or partially open. If partially open please explain in the comment section below
26. If Partiality Open, please explain
    (e.g. take out only, take-out and delivery, only delivery, closed to the public but open for business to business, etc.)
28. Do you have a take out or delivery service you would like the town to Promote?
    -- Select One --YesNo

    If answering Yes, please describe the service (take out, delivery, service hours)
30. Type of Service
    If you Answered yes, please describe the type of service being offered
34. Do you have surplus resources you want to share?

    1. PPE: Hand Sanitizer, Medical Masks, N'95 Respirators, Gowns/Scrubs, Gloves, Eye Protection)
    2. First Aid Supplies
    3. Personal Hygiene Supplies
    4. Food
    5. Shelter
    6. Volunteer Workers (sorting and labour)
    7. Volunteer Workers (pickup and delivery)
    8. Other (please list below)
36. Other/Notes:
38. Do you need resources?

    1. PPE: Hand Sanitizer, Medical Masks, N'95 Respirators, Gowns/Scrubs, Gloves, Eye Protection)
    2. First Aid Supplies
    3. Personal Hygiene
    4. Food
    5. Shelter
    6. Other (please list below)
40. Other/Notes:
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field