Burnaby Community Connections

Sponsor a Family
* required field

All your contact information will be kept strictly confidential.

Sponsor Name*

Contact Information

Contact Name*

Phone No.*

Fax No.

Address*

City*

Postal Code*

Email*

** Please include your e-mail address - we will not share it with anyone or send you spam. We prefer to communicate via e-mail to save time & money.

Alt. Contact.

Phone No.

Family Request

Please indicate the number of families you would like to sponsor under "request" next to the family size you would like to sponsor.

Family Size:	2 people	3 people	3-4 people
Max Cost:	$200+	$300+	$350+
Request:

Family Size:	4-5 people	5-7 people	7 or more
Max Cost:	$400+	$500+	$700+
Request:

Notes:

Oath of Confidentiality:
WHEREAS, it has been explained to me that any information about clients secured by me or available to me, in the pursuit of my duties with the Burnaby Christmas Bureau is of a coincidental nature, and I, the undersigned, hereby undertake to respect that confidentiality and to take all reasonable precautions to safeguard during & after my involvement.

Name:
** Please include all the names of the people who will have access to the information about the clients. (Seperate names by a comma)

Date: