Request Form

Let us know about those in need

Fill in the form below to request Christmas boxes for a family in need. Our charitable purpose is the prevention or relief of poverty, and we feel strongly that no-one should be at a disadvantage.

Who can refer? School teachers, social workers, health visitors, community workers, ministers, youth workers and charitable organisations dealing with poverty in Ayrshire

How many boxes are you requesting?

AgeNumber of GirlsNumber of Boys
0-6 months
6-12 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14-15 years
16-18 years
Over 18
Total00