Christmas basket distribution by registration - Fill out the form

Home > I want a Christmas basket

A Christmas basket from the guignolée is a set of foodstuffs

and basic products prepared by the CAB for individuals and families

in need during the holiday season.

Thanks to donations to the guignolée, we are able to offer a little comfort and light.

CHRISTMAS BASKET OPERATION 2026

Individuals in need who wish to receive a Christmas basket

must complete a form and submit it before Monday, December 1, 2026.

No requests will be accepted after this date.

To register for a basket:

2026-CHRISTMAS_BASKETS_FORM - impress form

Christmas Basket form
Your e-mail of confirmation *
first name + nick name *
Birthday *
Complet adress *
Phone number: *
Partner’s name *
Reason for the request *
Number of people living at home *
Last name, first name and income of those people *
Number of children you have custody of *
Child#1: last name, first name, age, gift interest
Child#2: last name, first name, age, gift interest
Child#3: last name, first name, age, gift interest
Month incomes
social weelfare: amount *
Employment insurance: amount *
Monthly family allowance: amount *
CSST/SAAQ: amount *
alimonyand/or children allowance: amount *
Federal pension (old Age security): amount *
Provincial pension( Qc pension board): amount *
Pension plan *
Employment incomes: montly amount *
Other incomes: amount *
Monthly expences:
Rent or mortgage: amount *
Taxes ( school and municipal) *
Electricity and heating: amount *
Telephone, internet, television: amount *
Monthly insurance( car, house, life): amount *
Medical fees: amount *
other: amount *
I consent to my local food assistance organization collecting, using, and retaining my personal information for the purpose of managing the Centre d’Action bénévole Ascension-Escuminac food assistance program. I may withdraw my consent at any time by writing to alimentation@cabmatapedia.com. As a beneficiary of CAB Ascension-Escuminac, I hereby agree not to hold the organization liable for any reason (e.g., food poisoning, etc.). Furthermore, I declare that the information provided in this questionnaire is truthful and subject to verification. * Any false or incorrect statement on your part will result in the immediate cancellation of your application. *	yes no
Date: *
Sign: *

- Online Form

Forms are available and can be returned to partner community organizationsas

well as all municipal offices in our Ascension-Escuminac territory.

**new**A *Christmas basket Mailbox* is available at the CAB, 3 Carillon Street, Matapédia. (no stamp required)

Christmas basket distribution by registration - Fill out the form

Month incomes

Monthly expences:

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