Apply for Services | Christmas Services

Indicates required field

Please fill out the form to the best of your ability. If you require help, please contact us.

In order for your application to be considered we require your address, phone number, and the names, gender and birth dates of all residents. The household name will be the name of a "primary resident", typically the person filling out this form.

The existing contact information is from an old system which, unfortunately, was missing birth dates. While we have most of your contact information, you will be required to enter birth dates for each person. If you do not know the exact date of birth, please select your best guess.

Household

Primary Resident

Enter the name, gender and birth date for the primary resident of the household.

First Name

Last Name

Gender

Female

Male

Other

Birth Date

Selecting the calendar icon will open up a calendar for choosing a date. Future dates will not be accepted.

Household

The name and contact details for your household. The household is all residents living in the same residence.

Household Name

The household name is set to be the full name of the primary resident. It will be updated automatically if the primary resident name is updated.

Phone

Primary Phone Number

The primary number we can use to contact you.

Cell Phone Number

Re-enter if same as primary.

Delivery address

Edit delivery address

Select to override the address auto-completion.

Street Address

Enter the address. The format should appear in this format: UNIT-STREET NUMBER-STREET NAME DIRECTION (e.g. 2-12122 68 Street NW).

City

Province

Only available in Alberta.

Postal Code

Enter a Canadian postal code in the format of H0H 0H0.

Buzzer

Provide a buzzer number if there is an apartment unit. (This field is required if a unit is provided.)

Delivery instructions

Provide details needed for delivery.

My mailing address is different from my delivery address

Select to enter a mailing address if it is different from the delivery address.

Mailing address

Edit mailing address

Select to override the address auto-completion.

Street Address

City

Province

Only available in Alberta.

Postal Code

Enter a Canadian postal code in the format of H0H 0H0.

Supplemental address information

Add supplemental information such as Buzzer or Delivery Instructions.

Enter the primary email address we can use to contact you.

Other residents

Add more residents in this household if there are any, aside from the primary resident. Provide name, gender and birth date for each resident.

If a baby is expected to be born by December 31 of the current year, please add the child as a resident and the expected due date.

Click Add to add a resident, or edit an existing resident if it is prepopulated. Any existing resident removed from this list will be removed from the household.

No residents entered. Please click Add below to provide residents.

Income

Monthly Income per resident

Required. Enter the monthly income per source of each adult resident. At least one income source is required for each resident over the age of 17, even if their income is zero. If an adult has multiple income sources then enter each income source on a separate line (with the resident's name each time).

Resident	Income source	Income ($)	Operations
Resident Name of the resident who receives the income.	Income source Income source for this resident.	Income ($) Monthly income in dollars.

Preferences

Service preference

Check all that apply. Selecting "Food" will display a second set of options.

Food

Toys for children 12 and under

Gift card for youth 13-17 years

Food preference

Choose how you prefer to receive the food gift. The hamper cannot be customized so if you have specific needs or requests please choose the gift certificate option.

Hamper

Gift certificate

Special needs

Identify any special needs. An intake worker will review and determine if they can be met.