Organization Information Form

Organization Information Form

Please complete this form as the next step in becoming a Delivery Partner with the Duke of Edinburgh's International Award - Canada. This form will be used to compile the necessary information needed for the agreement. Please note, this form should be filled out by a Senior Manager of your organization.
Preferred Language*

EnglishFrench
Organization Name*
Please use the legal name of your organization.
Organization Address *

Street Address

Street Address Line 2

City

Postal Code
Province/Territory
Is your mailing address the same as the address above?*

YesNo
Mailing Address

Mailing Street Address

Mailing Street Address Line 2

Mailing City

Mailing Postal Code
Mailing Province/Territory
Additional Organization Information
Please indicate whether your organizations is a registered charity or non-profit organization*

YesNo
Business or Non-Profit Incorporation Number (not required if you're a government school)*
Type of Organization *
Of your membership, how many young people are between the ages of 14 and 24?*
Does your organization have the following policies and procedures in place? Please note, if you do not have these in place our team will be able to support you to develop them in order to meet the licence standards. Please check ALL that are in place at your organization:*

Safeguarding and child protection policySerious incident reporting policyData protection policyHuman Resources policies for staffRisk management policyPublic liability insuranceWorker’s compensation/Employer’s Liability InsuranceAny other insurance policies that are required/desirable in the jurisdiction
Contacts

List of contacts required for the Award. In order to proceed with an agreement, it is required to have the contact to which the invoices are directed, the name of two Signing Authorities, an Authorizing Contact, and an Award Coordinator.
Invoice Contact Name

First NameLast Name
Invoice Contact Email
example@example.com
Signing Authority

A Signing Authority is an officer or agent of your organization with written authorization to commit the legal entity to a binding agreement. This person could be the same as the Agreement Holder.
Signing Authority #1 Name
First & Last Name
Signing Authority #1 Email
example@example.com
Signing Authority #2 Name
First & Last Name
Signing Authority #2 Email
example@example.com
Authorizing Contact - Agreement Holder

This person is the senior manager responsible for the Award Centre Agreement. This person has agreed the Award should be offered by your organization, has the power to sign the Agreement and holds the overall responsibility for ensuring adherence to the terms of the Agreement. This person can also be an Award Leader or an Award Coordinator. Typically, this might be a school principal or superintendent.
Authorizing Contact Name *

First NameLast Name
Authorizing Contact Role*
Role of the Authorizing Contact in your organization.
Authorizing Contact Email*
Please use an address which you check regularly. Ensure you have typed your email correctly.
Authorizing Contact Phone Number*
Please enter a valid phone number.
Award Coordinator - Primary Contact

This person takes overall responsibility for the delivery of the Award within their organization. They coordinate with other Award volunteers, liaise with senior management, and work with the Award staff to ensure smooth operation of the Award in their organization.
Award Coordinator Name *

First NameLast Name
Award Coordinator Role*
Role of the Award Coordinator in your organization.
Email Address*
Email address of the Award Coordinator
Phone Number*
Please enter a valid phone number.
I am aware of the requirements to become an Authorized Award Centre and I will provide all necessary documentation requested by the Duke of Edinburgh's International Award. *

YesPlease contact me
I am ready to enter into an Award Centre Agreement as the basis of the relationship between my organization and The Duke of Edinburgh's International Award.*

YesPlease contact me
I confirm that all the information given in this registration form is correct and accurate to the best of my knowledge.*

I Agree
Completed by*
Name of person who completed this form
Thank you so much for completing this form

You will receive an email shortly from Jotform Sign that includes the Agreement for your review. As a reminder, this needs to be signed by those individuals who have signing authority with your organization. The agreement outlines the relationship between The Duke of Edinburgh’s International Award - Canada and your organization as it pertains to delivering the Award.
PLEASE NOTE:

Jotform Sign agreements are emailed from Jotform Sign 'noreply@jotformsign.com'. Please ensure you and your signing authorities check your spam folders and add the 'jotformsign.com' domain to their safe list. Agreements will be sent out in one business day. Please contact your Award Staff if you do not see or receive your agreement within that time frame.
Account ID - HIDDEN {PLEASE PROCESS SUBMITTED FORM INTO ACCOUNT RECORD AND ADD TASK TO BUSINESS ACCOUNT MANAGER WITH TEXT: YOU HAVE A NEW AWARD CENTRE - THE ORGANIZATION INFORMATION FORM FOR [ACCOUNT NAME] HAS BEEN SUBMITTED. FOR THE QUESTION OF BEING AWARE OF AWARD REQUIREMENTS, ANSWER WAS: YES/PLEASE CONTACT ME. FOR READY TO ENTER INTO AN AGREEMENT, ANSWER WAS: YES/PLEASE CONTACT ME. IF NO BUSINESS ACCOUNT MANAGER ON ACCOUNT, ASSIGN TO KAREN}.
Should be Empty:

Organization Information Form

Additional Organization Information

Contacts

Signing Authority

Authorizing Contact - Agreement Holder

Award Coordinator - Primary Contact

Thank you so much for completing this form

PLEASE NOTE: