Number of people in your household:*-- Select --12 - 34 - 56+Its compulsory to select an optionHiddenSend Notifications?* Yes No HiddenApproved? Yes No User* HiddenSignature Option:*NOTE: If your device does not work with the e-signature option, please select "Text Signature." E-Signature Text Signature HiddenPicked up? Yes HiddenPicked-Up By:* Applicant Pick-Up Contact Other Approved By (MCSS Staff Name):* Applicant InformationName:* First Name Last Name Address:* Street Address Address Line 2 City British ColumbiaAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code HiddenDo you want to add your email to make registration faster next year?* Yes No Birthdate:* YYYY dash MM dash DD Email* Phone:*Picture ID type:*-- Select --BC IDMedical IDDriver's LicenseIndian Status CardSecure Indian Status CardNexus CardPassportPermanent Resident CardOtherID Number:* Spouse InformationName: First Name Last Name Address: Same as applicant address. Street Address Address Line 2 City British ColumbiaAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Birthdate: YYYY dash MM dash DD Email Phone:Picture ID type:-- Select --BC IDMedical IDDriver's LicenseIndian Status CardSecure Indian Status CardNexus CardPassportPermanent Resident CardOtherID Number: Applicant's Monthly IncomeApplicant's Monthly Income:*Income SourceMonthly Amount HiddenI am registering in-person at the Christmas Bureau and a staff member or volunteer has already approved my income verification. I am registering in-person at the Christmas Bureau and a staff member or volunteer has already approved my income verification. Staff confirmation code:* Please have a staff member or volunteer enter this code to complete your registration.Proof of income:*Please attach any relevant bank statements, pay stubs, tax assessments 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 Select files Max. file size: 50 MB. Registration InformationRegistering for:* Mission Food Centre: Food Hamper Christmas Bureau Toys Both Do you want to be sponsored?* Yes No Please note that your Christmas hamper will be delivered by the sponsor to your home.Dietary restrictions:* Yes No Please list any dietary restrictions:* Number of Dependents*Dependents*All fields must be filled out. Age will auto-calculate and cannot be entered manually.First NameLast NameBirthdateAgeGenderMedical ID -- Select One --MaleFemaleOther Hamper Pick-Up InformationFood Hamper Pick-up Dates: For pick-up please arrive anytime from 9am - 5pm between: December 6th - 15th, 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 InformationToy pick-up will be at the Mission Christmas Bureau at: The Junction Shopping Centre Unit 141 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.Toy Pick-Up Date:*-- Select Date --Monday, December 18th - Z, Y, X, WHiddenToy Pick-Up Date:*-- Select Date --Wednesday, December 6th - Z, Y, X, WThursday, December 7th - V, U, TFriday, December 8th - S, R, QMonday, December 11th - P, O, NTuesday, December 12th - M, L, KWednesday, December 13th - J ,I, HThursday, December 14th - G, F, EFriday, December 15th - D, C, B, AToy Pick-Up Time:*-- Select Time --9am - 11am11am - 1pm1pm - 3pm3pm - 5pmToy Pick-Up Time:*-- Select Time --9am - 11am11am - 1pm1pm - 3pm3pm - 5pmToy Pick-Up Time:*-- Select Time --9am - 11am11am - 1pm1pm - 3pm3pm - 5pmToy Pick-Up Time:*-- Select Time --9am - 11am11am - 1pm1pm - 3pm3pm - 5pmToy Pick-Up Time:*-- Select Time --9am - 11am11am - 1pm1pm - 3pm3pm - 5pmToy Pick-Up Time:*-- Select Time --9am - 11am11am - 1pm1pm - 3pm3pm - 5pmToy Pick-Up Time:*-- Select Time --9am - 11am11am - 1pm1pm - 3pm3pm - 5pmToy Pick-Up Time:*-- Select Time --9am - 11am11am - 1pm1pm - 3pm3pm - 5pmPick-up Contact: Same as applicant above. Name* First Name Last Name Phone:*Picture ID type:*-- Select --BC IDMedical IDDriver's LicenseIndian Status CardSecure Indian Status CardNexus CardPassportPermanent Resident CardOtherID Number:* Please list any additional information:AuthorizationDeclaration 1* I/We declare that the above information is true and give Mission Community Services Society and the Mission Food Centre/Christmas Bureau permission to verify this information. Declaration 2* I/We would like our information to be shared with MCSS Christmas Bureau for registration purposes only. Signature Option:*Please select an option to sign your registration. NOTE: If your device does not work with the e-signature option, please select "Text Signature." E-Signature Text Signature Applicant’s E-Signature:*Applicant’s Text Signature:* Date:* MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.