Christmas Sponsorship Application Form Date of Application (You must be registered as a Parker Street Food & Furniture Bank client to be approved) First Name Last Name Date of Birth Street Address City/Town Postal Code Phone Number Email Address Please upload a copy of your up to date lease with all family members listed, ID for all family members, and Notice of Assessment for all adults (19 years +) in the home (Required for returning and new clients) Would you like a Christmas Food Hamper included in your application Yes No If you selected yes to the question above, please indicate a protein choice Turkey Halal Vegetarian Child Name #1 Health Card # (last four digits only) Gender Date of Birth Clothing Size Shoe Size Christmas Wish List Child Name #2 Health Card # (last four digits only) Gender Date of Birth Clothing Size Shoe Size Christmas Wish List Child Name #3 Health Card # (last four digits only) Gender Date of Birth Clothing Size Shoe Size Christmas Wish List Child Name #4 Health Card # (last four digits only) Gender Date of Birth Clothing Size Shoe Size Christmas Wish List Child Name #5 Health Card # (last four digits only) Gender Date of Birth Clothing Size Shoe Size Christmas Wish List Additional Child/Children Christmas Wish List Number of Children Number of Adults Total Family Size I understand that all family members listed above must be registered under my Parker Street Food & Furniture Bank account in order to receive gifts for each family member. Yes No I agree to have my name and the information included in this application to be submitted for informational purposes for Parker Street Food & Furniture Bank. Yes No I understand that this information will be held in the strictest confidence and will not be released to any outside parties by Parker Street Food & Furniture Bank. Yes No Submit
