WAITLIST 2025 BACKPACK PROGRAM Application Form

2025 Backpack WAITLIST

As of Aug 31, the 2025 Backpack registration has closed. Please complete this form to be added to our waitlist. You will be notified if there are any remaining backpacks.
Parent/ Guardian Name:*

First NameLast Name
Address

Street Address (House/ Building Number and Street Name)

Street Address Line 2 (If you have an apartment #, Unit #, or Suite #)

CityProvince

Postal Code
Phone Number 1:*
This number will be used to contact you regarding your backpack pick-up time. It is essential that you include a valid phone number.
Phone Number 2:
Please enter a valid phone number.
Email:
This email may be used to contact you for a survey, related programs, contests, and give aways throughout the year. Please enter a valid email address.
Yearly Household Income:
This information does not impact your eligibility for this program, and will only be used collectively, as an average for reporting and funding purposes. Entering $0 is not an option.
Have you used the Town House or NW Kinsmen Backpack Program before?*

YesNo
If yes, what was the last year you accessed the Backpack program?
This is for reporting purposes only, and will not reflect eligibility.
Total number of students you're requesting backpacks for:*
If you require more than 5 backpack registrations, please contact Town House once you've completed your form.
Supplies Requested For:

Please include the Name, Date of Birth, Grade, and gender for each student in your household who requires a backpack and supplies.
Please Note:

Although we receive some monatary donations and purchase some supplies ourselves, many of our backpacks and supplies are donated by community members. Therefore some items may have colours or characters that are traditionally viewed as perfered by male or female students.

While we take every effort to distribute gender neutral supplies, we are limited in what we can offer based on donations. Please include your students gender identity if they would prefer, or be comfortable with items displaying colours or characters that are traditionally associated with certian genders.

Answering this question is not required and is simply a means of helping us choose supplies your student will be happy with.
Student 1:*

First NameLast Name
Gender
AGE*
DOB*

MonthDayYear
Grade*
School*
Student 2: (Please leave this section blank if there is no 2nd student.)

First NameLast Name
Gender
AGE
DOB

MonthDayYear
Grade
School
Student 3: (Please leave this section blank if there is no 3rd student.)

First NameLast Name
Gender
AGE
DOB

MonthDayYear
Grade
School
Student 4: (Please leave this section blank if there is no 4th student.)

First NameLast Name
Gender
AGE
DOB

MonthDayYear
Grade
School
Student 5: (Please leave this section blank if there is no 5th student.)

First NameLast Name
Gender
AGE
DOB

MonthDayYear
Grade
School
Should be Empty:

2025 Backpack WAITLIST

Supplies Requested For: