Application for Assistance through the 2021 Christmas Giving Network of Greater Victoria. Agency is Salvation Army Connection Point Church & Resource Centre.

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This application process enables families and individuals to obtain assistance at Christmas from ONE agency.

Email *

Please read the following information before completing your application.

1. You will submit this application to only one agency to receive help from the Christmas Giving Network.
2. Your signature is required upon your appointment to pick-up your application.
3. Identification will be required (including dependents) upon Pick Up/ Delivery.
4. In order to process your application, please ensure that the phone number, mailing address and email address are correct. If we cannot contact you, we cannot provide a hamper.

I have read the information in the beginning and have NOT applied to more than one agency for this. *

Yes

Required

First Name *

Last Name *

Apartment # (If applicable) *

House # *

Street Name *

City *

Langford

Colwood

Victoria (This location may be closer https://salvationarmyvictoria.ca/next-steps-resource-centre/)

Sooke

View Royal

Saanich (This location may be closer https://www.pointful.ca/)

Other:

Birthdate (MM/DD/YYYY) *

YYYY

Phone number *

Email Address

Now, you may enter other residents at your home address. Enter 'None' if this does not apply to you.

Please list first and last name, gender, and birthdate (MM/DD/YYYY) in the long answer text box below. The following images show what the application form looks like.

Other Adults (spouse, adult children 18+ years) (INCLUDE BIRTHDATE) *

Children (17 years and younger) (MUST INCLUDE BIRTHDATE) *

All persons listed above live at my address

Yes

No (Then please update your form before proceeding)

Clear selection

Date of Completion

YYYY

When you come to pick-up your hamper, we will ask for your signature to complete the applicant process.

We will call your phone number to book appointments for Christmas hamper pick-up over December 20th-23rd, 2021 between 9:30 am to 3:00 pm at our location #103-737 Goldstream Ave. Langford, BC B9B 2X4. Call us at 778-817-1141 for assistance.

Thank you for your application. The Christmas Giving Network includes various agencies and food banks in Greater Victoria who assist at Christmas and share their applicant information to ensure that families and individuals can be served accordingly.

A copy of your responses will be emailed to the address you provided.

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