1Online Application – Toys/Food

PLEASE NOTE: Only clients currently in our database may use this submission form. Other applicants will be advised to call the office to confirm information before their application can be entered. This will help to alleviate the need to have our investigation team conduct additional screenings. We appreciate your patience and understanding.

As always, we cannot accept referrals. This helps ensure all information is correct.

 

DETAILS FOR DISTRIBUTION: pick up or delivery dates/ location when available **** TBA

 

REFERRAL TO OTHER AGENDIES FOR OUT OF TOWN FAMILIES:

 

BLENHEIM – 519-676 8409
DRESDEN – 519-683-4862
MERLIN – 519-784-1999
RIDGETOWN/BOTHWELL – 519-674-3765
THAMESVILLE – 519-401-1085
TILBURY – 519-682-2268
WALLACEBURG – 519-627-8257
CHATHAM SALVATION ARMY – 519-354-1430
CK HELP – 519-990-5178
OUTREACH HUNGER – 519-351-8381

 

Please be patient with us as we try to fulfill our commitment to families in Chatham-Kent. Our promise to ensure that there is ‘no child without a Christmas’ will not be compromised. The impact of the current challenges has affected us all; but with your support and understanding we will be successful once again.

No Child Without A Christmas 2021 Online Form

Name(Required)

How to Reach You

Please supply both a phone number and an email if possible.

Information about ADULTS

Information about TEENS

Please list the name(s) and age(s) of TEENS currently living in the home.
Please enter a number from 16 to 19.
Please enter a number from 16 to 19.
Please enter a number from 16 to 19.
Please enter a number from 16 to 19.

Information about CHILDREN living in the household (ages 15 years and under)

Please enter a number from 0 to 15.
Please enter a number from 0 to 15.
Please enter a number from 0 to 15.
Please enter a number from 0 to 15.
Please enter a number from 0 to 15.
Please enter a number from 0 to 15.
Please enter a number from 0 to 15.

Other Information

Delivery or Pickup Information

To receive Gift Baskets, do you prefer:(Required)

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