Organization Name
*
Legal Name (If different from above)
DELIVERY Address
*
City
*
Postal Code
*
Province
*
Contact Name
*
Telephone Number
*
CRA Number (if applicable):
Email Address
*
Website/Social Media Address
Type of Organization
*
Shelter
Transitional Housing
Out of the Cold Program
Private Organization
Other
Number of Socks Requested -MEN
*
N/A
100
300
500
800
1000
more than 1000
Number of Socks Requested -WOMEN
*
N/A
100
300
500
800
1000
more than 1000
Number of Socks Requested -CHILDREN
*
N/A
100
300
500
800
1000
more than 1000
How Do You Want to receive your socks?
*
Pickup
Delivery
If you chose DELIVERY - you will be notified when the order is ready and provided with a delivery date. All deliveries must have someone present to receive them. If you chose PICKUP - you will receive an email when the order is ready for pickup.
Comments/Additional Information
Security Code
*