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    NOTE: If your device does not work with the e-signature option, please select "Text Signature."
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  • Applicant Information

  • YYYY dash MM dash DD
  • Spouse Information (Optional)

  • YYYY dash MM dash DD
  • Applicant's Monthly Income

  • Income SourceMonthly Amount 
  • Please have a staff member or volunteer enter this code to complete your registration.
  • Please attach any relevant bank statements, pay stubs, or other documents for the income listed above.

    MOBILE ONLY: On mobile and tablet devices when tapping "Select files" you will have the option to select an existing picture/file or take a new picture using the device camera.

    Drop files here or
    Max. file size: 50 MB.
    • Registration Information

    • All fields must be filled out. Age will auto-calculate and cannot be entered manually.
      First NameLast NameBirthdateAgeGenderMedical ID 
    • Hamper Pick-Up Information

      Food Hamper Pick-up Dates:

      For pick-up please arrive anytime from 9am - 5pm between:

      December 7th - 16th, Monday - Friday

      Location

      Food Centre/Christmas Bureau
      32646 Logan Ave
      Mission, BC V2V 6C7

      PLEASE NOTE: Toys and Hampers have different pickup locations.

    • Toy Pick-Up Information

      Toy pick-up will be at the Mission Christmas Bureau at:

      The Junction Shopping Centre
      32555 London Ave, Mission, BC V2V 6M7

      Christmas Bureau Toy Pick-up Dates:

      Pick-up is based on last name, please arrive anytime during the time slot selected below.

      PLEASE NOTE: Toys and Hampers have different pickup locations.

    • Authorization

    • Please select an option to sign your registration.
      NOTE: If your device does not work with the e-signature option, please select "Text Signature."
    • Reset signature Signature locked. Reset to sign again
    • MM slash DD slash YYYY
    • This field is for validation purposes and should be left unchanged.