Your details

Tell us who is applying. We use this to contact you about your application and on pickup day.

Questions marked * Required must be answered before you can continue.

Primary Applicant Name

First name * Required

Last name * Required

Is there a second adult applicant in the home? NoI am the only adult applying YesThere is a second adult applicant in the home

Are there any other adults living in the home aged 19+

Are you applying for any children? * Required YesI am applying for one or more children aged 0-18 years old NoNo children on this application

Mobile number * Required

Email address * Required

Street address * Required

Unit / apartment

City or district * Required

Province * Required

Postal code * Required

Your children

Add each child you are applying for, one at a time. Children aged 0 to 10 receive a toy bag. Children aged 11 to 18 receive a RIOCAN Teen Card.

Please note: enter the age and gender that fit your child best — this is your choice as a parent, and does not have to match a birth certificate. We use it only to match a gift your child will enjoy.

Total number of people you are applying for 1

Pickup and transport

Where would you like to collect your items? * Required

How will you get your items home? * Required I have my own transportI will drive or have a vehicle Someone else is collecting for meA friend or family member will pick up on my behalf I need a courtesy ride homeFrom our main warehouse only. You still need to get to us.

Turkey Yes pleaseInclude a turkey, while supplies last No thank youWe cannot use a turkey this year

Household finances

Enter your household's monthly figures. Include everyone in the home. Leave a box blank if it does not apply to you.

Money coming in each month

Main source of income

OW, ODSP, CPP, pension or disability

Work income (from a job)

Child tax credit

Other income

Money going out each month

Rent, mortgage or property tax

Utilities

Internet

Cell phone

Insurance

Work expenses

Maximum $500 per month.

Other expenses

Do you receive Ontario Works or ODSP? Ontario WorksI receive Ontario Works ODSPI receive the Ontario Disability Support Program

Supporting documents

We need to see proof of who you are, where you live, who depends on you, and the figures you entered. You cannot submit without the required documents.

You can photograph documents with your phone. A single PDF may contain several documents. Each file must be under 8 MB.

Finishing up

Best time to reach you by phone * Required

Anything else you would like us to know?

Your signature * Required

By signing you confirm the information on this application is true and complete. Providing false information may mean your application is denied.

Applications are not open right now

Your details

Primary Applicant Name

Your children

Pickup and transport

Household finances

Money coming in each month

Money going out each month

Supporting documents

Finishing up

Thank you — your application is in

What happens next