Hamper Recipient - Rhythm Aura. An expression of hope, love and faith.

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tel: 1800 62 88 37 [email protected]

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Rhythm Christmas Appeal 2022

Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address City State Postcode

Please tell us about your situation

Are you a Concession Card Holder?(Required)

Health Care Card

Pension Card

Disability Card

Veterans Card

I do not have a Concession Card

Please note you will be requested to provide a sighting of your card for verification purposes.

Your Current Circumstances

Please inform us why you would like to receive a hamper

How many people at your address?(Required)

How many Children (under 17) are currently living with YOU?(Required)

Other

Children Information

Please let us know that names, gender and age of each child living with you. Eg. Ben / 4 / Boy or Sarah / 13 / Girl

Name

This field is for validation purposes and should be left unchanged.

* A member of the Rhythm Church team will be in contact with you to arrange a suitable time for delivery in person. A visual inspection of your government issued benefits card will be required.

** Please note that application does not guarentee a hamper, each case will be considered and due to the overwhelming need, priority will be given to households in postcode 4551.