Low Income Families Application Form

To see if you qualify, please enter your details below. You can find your information on your Canada Child Benefit (CCB) Notice.

To access your CCB Notice, log into your account on the Canada Revenue Agency (CRA) website. Or register a new account.View Details

Please note that your information must match what appears on your CCB Notice.

Full Name

Unit#

Street Number

Street Name

City

Province

Postal Code

Last 4 digits of SIN

Family Net Income CCB

Base Year

Email address

Confirm Email address

Preferred language of communication

I will upload my CCB Notice in the next step and confirm that I have blacked out the first five digits of my SIN number and have left only the last four digits visible

By continuing to use this form, you consent to allowing the collection and use of the information entered above. Please click the Next button to accept and continue your application.

Collected and retained information will be used for determining eligibility for the Internet for Good offer. Retained records will be purged within a maximum of 7 years from the date of entry and in some cases immediately. Please don’t share any sensitive information in the form outside the requested information. Sensitive information includes personal and confidential information. The definition of personal information can be found at our TELUS Privacy Commitment