• ProjectKindness – Self Referral Form

  • This form is for individuals and families who would like to refer themselves for support through ProjectKindness. All information provided will be treated with strict confidentiality and used solely to assess your needs and coordinate appropriate support.

    Please note that ProjectKindness offers a delivery service within a 5km radius of our Alexandria base. Once your referral has been submitted, a member of our team will contact you within 24 hours to arrange a suitable collection or delivery time.

    We look forward to supporting you and your family.

  • Your Details

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  • What is your date of birth?*
     / /
  • What is your gender?*
  • Do you identify as being of Aboriginal and/or Torres Strait Islander descent*
  • Does you identify as culturally or linguistically diverse (CALD)?*
  • What challenges or barriers are you currently facing? (Please select all that apply)
  • How did you hear about ProjectKindness?
  • At ProjectKindness, we sometimes share anonymous stories to help our supporters understand the difference their generosity makes. With your permission, may we share a brief summary of your situation?Any information shared would be de-identified, meaning it would not include your name, address, or any details that could identify you or your family. This is entirely your choice and will not affect the support you receive.*

  • Support Requested

    Please note that aside from the hampers listed below, we are unfortunately unable to offer any other items or services.

  • The Food Kindness Hamper

    Suitable for adults and children.

    The Food Kindness Hamper provides practical and reliable support through non‑perishable food items. Designed to ease immediate pressure, it helps individuals and families put a meal on the table during challenging times. Each hamper includes carefully selected shelf‑stable items chosen for practicality, longevity, and ease of use.

     

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  • The Baby & Toddler Kindness Hamper

    Suitable for children from newborn to 3 years of age.

    The Baby & Toddler Kindness Hamper is lovingly designed to support babies, toddlers, and their families through the earliest and most important stages of life. Thoughtfully curated, this Kindness Hamper includes practical essentials and comforting items that help nurture safety, wellbeing, and a sense of belonging from day one. Hampers may include clothing, baby wipes, bottles, soft toys, wraps, cosy blankets, and age‑appropriate toys to support comfort and early development.

     

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  • The Creative Kids Kindness Hamper

    Suitable for children aged 4 to 12 years.

    The Creative Kids Kindness Hamper supports children as they grow, learn, and express themselves through play and creativity. Each hamper includes age‑appropriate books, engaging toys, and arts and crafts materials that encourage imagination, confidence, and joyful exploration.This Kindness Hamper supports children’s wellbeing and reminds them that kindness, play, and creativity matter.

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  • Child/ren Details

    Please provide details for each child, if applicable. This section only needs to be completed if you have selected a Baby & Toddler or Creative Kids hamper above.

    Children’s Clothing: ProjectKindness is able to provide children’s clothing up to size 5 only.

    Please note that any child you are requesting a hamper for must also be listed on your Centrelink statement. This is a requirement for submitting your application at the end of this form.

    • Child 1 
    • Child 2 
    • Child 3 
    • Child 4 

  • Proof of Centrelink or Income Support

    Please upload an image, scan or screenshot of your latest Centrelink or Income Statement. This statement must have been received within the last 14 days.

    IMPORTANT: Please note that ProjectKindness is unable to respond to requests without correct file upload. Please call us on m. 0431 537 727 to discuss should you require support in obtaining and/or uploading correct document.

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