Agency - New Application

Referral Agency

New Application
As a Registered Charity, Sport Central’s mandate is to retrieve, repair, recycle and redistribute sports equipment to kids aged 4-17 in families facing financial hardship. We continually assess and accept social agencies / services who can assist us with reaching more children. To become a referring agency please complete this application.

If you have questions about the information requested below, please call or email us.

780-477-1166 / referrals@sportcentral.org
Organization Information:
Organization Name
Organization Phone Number
Please enter a valid phone number.
Organization Website Link
Organization Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Contact Information:
Your Name

First NameLast Name
Organization Position
Mobile Phone
Other Phone
Email Address
example@example.com
Organization Profile:
Please include a short description of your organization
On average, how many children does your organization work with each year?
How does your organization assess families for social / financial aid?
Does your organization provide translation services for clients if needed?

Please provide the percent (%) of children your organization assists annually

Next Steps:
Within 2 - 4 business days a Sport Central representative will reach out to review your application. Once approved, your organization will receive an organization ID number. Your employees / volunteers can then submit their contact information to be setup as referral partner.

Instructions as well as resource material will be provided for each referral partner. If requested, Sport Central can also provide a brief training or information sharing seminar for your employees / volunteers.

In addition, we appreciate any endorsement or promotion your organization can provide to raise awareness of our services. Promotional material including brochures & posters are available upon request.
Terms and Conditions:
As an authorized representative of my organization, I certify that the information on this form is correct to the best of my knowledge. We will comply with the necessary documentation and implementation plan as outlined by Sport Central.
11847 Wayne Gretzky Drive North, NW Edmonton, Alberta T5B 1Y2 780.477.1166 | www.sportcentral.org | thekid@sportcentral.org
Should be Empty:

Referral Agency