Page 1 of 2 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 Page 2 of 2 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:
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