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Register for a box
Please fill the form below to register for a box
1. Contact info*
2. Are they in receipt of benefits*
Yes
No
3. Household demographic*
4. Ethnicity*
Select
White-English/Welsh/Scottish/Northern Irish/British
White-Irish
White-Gypsy or Irish traveler
White-Any other white background
Mixed-White and black Caribbean
Mixed-White and black African
Mixed-White and Asian
Mixed-Any other mixed/multiple ethnic background
Asian-Indian
Asian-Pakistani
Asian-Bangladeshi
Asian-Chinese
Asian-Any other Asian background
Black-African
Black-Caribbean
Black-Any other Black/African/Caribbean background
Other-Arab
Other-Any other ethnic group
5. Age*
18-24
25-34
35-44
45-54
55-64
Over 65
6. What time is most suitable for you to collect on Saturday 23rd of December (multiple selections allowed)*
9:00am-9:30am
9:30am-10:00am
10:00am-10:30am
10:30am-11:00am
11:00am-11:30am
11:30am-12:00pm
12:00pm-12:30pm
12:30pm-01:00pm
01:00pm-01:30pm
01:30pm-02:00pm
02:00pm-02:30pm
02:30pm-03:00pm
03:00pm-03:30pm
03:30pm-04:00pm
04:00pm-04:30pm
04:30pm-05:00pm
05:00pm-05:30pm
05:30pm-06:00pm
Submit
