Required fields are marked with asterisks (*)

This program is funded by many generous local donors which consist of farmers, small businesses, local community members and companies. We thank them for their continued support each year!

Christmas Hamper Application

Is this a

Request

Nomination

Recipient Name

Drop off address

How can we reach the recipient?

Saddle Hills County will be contacting the recipient to arrange delivery.

Household contact

Phone number

Email Address

Adults living at the residence

These must be filled out - use full names

First and Last Name

Age

Gender

First and Last Name

Age

Gender

Additional Adults (please provide age and gender)

Children (under 18) living at the residence

These must be filled out - use full names

First and Last Name

Age

Gender

Relationship to Adult(s)

First and Last Name

Age

Gender

Relationship to Adult(s)

First and Last Name

Age

Gender

Relationship to Adult(s)

First and Last Name

Age

Gender

Relationship to Adult(s)

First and Last Name

Age

Gender

Relationship to Adult(s)

Additional Children (please provide age, gender and relationship)

Gift ideas for children under 18 (gift limit $50.00)

Dietary Restrictions or Preferences

By checking this box, which functions as your legal signature, you confirm that you have answered all of the questions accurately and honestly.

I understand that checking this box constitutes a legal signature

Please send me a pdf copy of this form

Yes

Get applications in to us early - limited number of hampers available. Application Deadline - December 13, 2024, 4:30 p.m.

Saddle Hills County will be contacting the recipient to arrange pickup or delivery of their hamper. Please note that the County has the right to deny any person or persons a hamper subject to misleading information being provided on this application.

Stay up to date on the Saddle Hills activities, events, programs and operations by subscribing to our eNewsletters.