Registration For Christmas Assistance in Bowmanville Home » Registration For Christmas Assistance in Bowmanville Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *EmailConfirm EmailPhone *Please confirm you live in Clarington *Please confirm where you live, based on Government issued ID.Yes, I live in ClaringtonNo, I do not live in ClaringtonPlease note that we are only able to provide support for residents of Clarington.Please confirm you have NOT previously registered for 2024 Christmas assistance with any other agency as we are not able to process duplicate registrations. *Please selectI live in Clarington and have not registered with any other agencyI have registered elsewhereAddress *Address Line 1Address Line 2CityState / Province / RegionPostal CodeLayoutDate of Birth (mm/dd/yyyy) *Age *Gender *MaleFemalePrefer not to sayLayout#of Adults in Household (18 & over) * *#of Children in Household (17 & under) *Adult 2 Name *FirstLastLayoutAdult 2 Date of Birth (mm/dd/yyyy) *Adult 2 Age *Adult 2 Gender *MaleFemalePrefer not to sayAdult 3 Name *FirstLastLayoutAdult 3 Date of Birth (mm/dd/yyyy) *Adult 3 Age *Adult 3 Gender *MaleFemalePrefer not to sayAdult 4 Name *FirstLastLayoutAdult 4 Date of Birth (mm/dd/yyyy) *Adult 4 Age *Adult 4 Gender *MaleFemalePrefer not to sayAdult 5 Name *FirstLastLayoutAdult 5 Date of Birth (mm/dd/yyyy) *Adult 5 Age *Adult 5 Gender *MaleFemalePrefer not to sayAdult 6 Name *FirstLastLayoutAdult 6 Date of Birth (mm/dd/yyyy) *Adult 6 Age *Adult 6 Gender *MaleFemalePrefer not to sayChild 1 Name *FirstLastLayoutChild 1 Date of Birth (mm/dd/yyyy) *Child 1 Age *Child 1 Gender *MaleFemalePrefer not to sayChild 2 Name *FirstLastLayoutChild 2 Date of Birth (mm/dd/yyyy) *Child 2 Age *Child 2 Gender *MaleFemalePrefer not to sayChild 3 Name *FirstLastLayoutChild 3 Date of Birth (mm/dd/yyyy) *Child 3 Age *Child 3 Gender *MaleFemalePrefer not to sayChild 4 Name *FirstLastLayoutChild 4 Date of Birth (mm/dd/yyyy) *Child 4 Age *Child 4 Gender *MaleFemalePrefer not to sayChild 5 Name *FirstLastLayoutChild 5 Date of Birth (mm/dd/yyyy) *Child 5 Age *Child 5 Gender *MaleFemalePrefer not to sayChild 6 Name *FirstLastLayoutChild 6 Date of Birth (mm/dd/yyyy) *Child 6 Age *Child 6 Gender *MaleFemalePrefer not to sayChild 7 Name *FirstLastLayoutChild 7 Date of Birth (mm/dd/yyyy) *Child 7 Age *Child 7 Gender *MaleFemalePrefer not to sayChild 8 Name *FirstLastLayoutChild 8 Date of Birth (mm/dd/yyyy) *Child 8 Age *Child 8 Gender *MaleFemalePrefer not to sayChild 9 Name *FirstLastLayout (copy)Child 9 Date of Birth (mm/dd/yyyy) *Child 9 Age *Child 9 Gender *MaleFemalePrefer not to sayComments or QuestionsOur Privacy Policy has been updated Click to read and review complete Privacy PolicyClick to confirm consent to privacy policy *I agree to the updated Privacy Policy & Give Consentinformation is complete and accurate *YesBy Submitting this form I certify all information is complete and accurate. I have not registered for Christmas assistance with any other agency and I give permission for email communications with The Salvation Army Bowmanville for follow-up as required.I agree and have signed this electronically *Electronic SignatureSubmit
