Holiday Hamper Program · Custom Portal

Step 1 - Contact Information
Step 2 - Add Family Members

Please fully complete this application before submitting it. Only permanent household members may be added to your form for Holiday support. After completing your application, you will receive an email notifying you that it was submitted, and we received it. If you do not receive this confirmation email, please contact the Client and Community Outreach Coordinator at kaitlyn.lalonde@kanatafoodcupboard.ca or call 613-836-7847, Monday to Friday between 9am-1pm.

Your Information

First Name

Last Name

Date of Birth

Day

Month

Year

Date of Birth

I Identify my Gender As

Primary Phone

Alternate Phone Number

Street Address

Unit / Apt

Buzzer Number

Area

City

Province

Postal Code

Notes

Please provide any additional information that you feel is important for your registration. If you/your household family members have dietary considerations, please feel free to include them. (While we do our best, we will not be able to accommodate all dietary requests.)

This year, our Holiday Hamper program will provide several different ways to receive assistance to have a holiday meal. Please select the option that works best for your family:

What Protein Option Would you Like?

The following page will ask you to add information about your household family members, if any. Please note that only permanent household members (not guests) can be added to your Holiday Hamper application.