Christmas GIVING Network - CFAX Santas Anonymous Society

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Christmas
GIVING
Network
This application process allows Families and/or Individuals in
need at Christmas to obtain assistance from ONE of the
agencies listed below. If one agency reaches its capacity, your
application may be forwarded to one of the other agencies.
Please submit your application as soon as possible to ensure
that you will be accepted. Deadline is December 6, 2013.
of Greater Victoria You will receive assistance this Christmas from only
2013
Mail
one agency.
or drop off your application directly to the 1 AGENCY chosen.
DEADLINE: December 6, 2013.
C-FAX Santas Anonymous
1420 Broad Street, Victoria, BC V8W 2B1
Providing new toys for children 17 and under, with food hampers and a food voucher
for the family. Santas assists families WITH children only.
Times Colonist Christmas Fund
2621 Douglas Street, Victoria, BC V8T 4M2
Assists individuals and families in need at Christmas.
If you are willing to share your name and story with a Times Colonist reporter please check here if we
can contact you. _______
The Salvation Army
2695 Quadra Street, Victoria, BC V8T 4E3
Providing new toys for children 12 and under, (up to 18yrs as donations allow) and food
hampers for their family. This agency serves individuals & families.
The Mustard Seed
625 Queens Avenue, Victoria, BC V8T 1L9
Providing new toys for teens & tots and Christmas Hampers including turkeys, for
Families with Children, Adult Families and Individuals
St. Vincent de Paul
828 View Street, Victoria, BC V8W 2K6
Providing toys for families with children 17 and under, with food voucher for the family.
Also assists Seniors over 60 with a food voucher.
Other agencies who assist at Christmas may share their
applicant information to ensure that more families can be served.
SEE PAGE 2 FOR APPLICATION GUIDELINES AND APPLICATION FORM
APPLICATION GUIDELINES
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1. You will receive help from only one agency.
2. Submit one application to one agency only.
3. Your signature is required at the bottom of this application.
4. Identification will be required (included dependents) upon pick up.
PLEASE PRINT CLEARLY – application deadline December 6, 2013
First Name:
Last name:
Address: Apt. #
House #
Street Name:
Address: City
Postal Code:
Email Address:
Phone Number:
(
)
MY REQUEST FOR HELP ALSO INCLUDES THE FOLLOWING PEOPLE WHO LIVE AT MY ADDRESS:
OTHER ADULTS (spouse, adult children 18+)
FIRST NAME
LAST NAME
GENDER
CHILDREN (17 years and younger):
FIRST NAME
LAST NAME
GENDER
AGE
A SIGNATURE BELOW IS REQUIRED FOR US TO HELP YOU.
By signing below, I confirm that all those listed above live at my address and need a helping hand.
Signature of applicant: ___________________________________ Date: ______________________
SEE REVERSE SIDE OF FORM FOR DROP-OFF LOCATIONS AND MAILING INFO
FOR
OFFICE
USE ONLY
RECEIVED
DATE:
CHECKED BY:
ENTERED BY:
CONTACT ID#:
TRANSFER TO: