Holiday Hamper Program Form 2022

To be part of the Denman Island Holiday Hamper Program, please fill out this form and submit it by Dec. 12. If you have any questions, email us at dices.communityprograms@gmail.com or call us at 250 335 2058.

Name *

First

Last

Email *

Phone

What is the best way to contact you? *

• Phone
• email

Street address for delivery

Special driving instructions?

Would you prefer to pick up your hamper at the school? (If so, please mark "Yes" and provide a working phone number.)

• Yes
• No

Dietary Restrictions

(eg. vegan, gluten-free, nut allergy)

Please indicate the food preparation facilities that are available to you

• Fridge
• Ove
• Stove
• Freezer

Please indicate the number of individuals in your household (this helps us choose gifts and estimate food purchases) - number of: Male Adult, Female Adult, Non-Bindary Adult, Male Child + Ages, Female Child + Ages, Non-Binary Child + Ages, Pets)

Submit

Hampers will be delivered around 2pm on Thursday, December 22nd.  They cannot be left unattended on porches or doorsteps, please be home to receive your hamper. 

We do our best to accommodate dietary needs; however, please note that we are not always able to meet these requests. Thank you.