SFU Dining offers the Made-Without-Gluten Pantry to students with gluten intolerance. The designated space within SFU Dining Commons, features a variety of snacks, meals and condiments made without gluten to supplement the overall dining experience. The room is equipped with a refrigerator, freezer, toaster, microwave oven, and blender so students can heat-up or assemble items. To keep the room as safe as possible for those students with gluten intolerance, access is restricted to students meeting the admission criteria. Please fill out this request form to see if you qualify for access to this room.

Do you agree with this statement?

* 1. The information you provide via this survey is collected under the authority of the University Act (R.S.B.C 1996, c.468). It is related directly to and needed by the University to consider you to obtain access to the Made-Without-Gluten Pantry. The information will be used by SFU Dining to process access, and will be used for no other purpose. Names, e-mails and student numbers will be may be used to contact the students regarding the Made-Without Gluten Pantry, if needed. If you have any questions about the collection, use and disclosure of this information please contact Dan Traviss, Director, SFU Food, 778-782-9669.

Yes

No

Today's Date?

Please select today's date.

Please provide your contact information

First Name

Last Name

Email

Student ID

Are you on a Meal Plan?

Select

Yes ((Kindly note, this program is only available to students on a Meal Plan)

Do you currently have celiac disease, a wheat allergy, or non-celiac gluten sensitivity?

Select one

Yes

No

As a result of gluten intolerance, are you required to follow a gluten-free diet?

Select one

Yes

No

To maintain a safe and secure environment, we ask you to please refrain from requesting access to the Made-Without-Gluten Pantry if you can enjoy gluten-containing products occasionally. Check “OK” to confirm your understanding of this statement.

Select

OK