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Donation Requests

Community Support Form
Organization Name:  *
Charitable Registration Number:
Organization Address:  *
Organization City:  *
Organization Postal Code:  *
Key Contact First Name:  *
Key Contact Last Name:  *
Contact Phone Number:
     *
Contact Cell Number:
   
Contact Email Address:  *
Confirm Email Address:  *
Name of Event:  *
Describe the event:  *
What is the date of the Event?
Open the calendar popup.
Attendee Estimate:  *
What level of support are you requesting?:


How will the contribution be used?:


How will you recognize our contribution?  *
Type the characters you see in the picture.

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