Pictou County Christmas Fund

Registration Form

Please complete all applicable fields of the registration form, including at least one form of contact (phone or email).

Please note: Registration deadline is November 28th, 2025

Registrations will not be accepted after this date.

First Name

Last Name

Date of Birth

Mailing Address (1)

Mailing Address (2)

Town

Postal Code

Phone

Please list additional household members, including ages of children.

Grocery gift cards will be issued based on family size. While we will do our very best to fill every request for assistance, we are unable to accept any registrations after the posted deadline.

**Distribution will take place at the Summer Street Industries, located at 72 Park Street, New Glagow on December 16th and 18th, 2025 between 11:00 AM and 2:00 PM. Please note, you will be required to present id/health card, including cards for all registered family members.**

I have reviewed and understand the terms of the registration process for the Pictou County Christmas Fund. In addition, I acknowledge the information I have provided is correct to the best of my knowledge.

I agree with this statement.