Community Essentials Nomination Form

Community Essentials Nomination Form

Nominate a charity, non-profit, youth group, or community support organization to receive their complimentary $100 Supply Gift Certificate. You have the option to add to the amount by contributing $100 of your own, and we’ll add another $50 for a $250 certificate! Each organization may receive a maximum of two certificates per cycle. If your first choice has reached their limit, we can apply your nomination (and contribution if applicable) to your second-choice group.
Your Business Name*
Your Name*
Your Email*
example@example.com
Your Phone Number (optional)
Name of the Non-Profit Organization You Are Nominating*
Website URL of Organization*
Contact Email or Phone for the Non-Profit (if known)
Why are you nominating this organization?
Would you like to top up your nomination and increase the support they receive?*

No - please provide the standard $100 certificateYes - I’d like to contribute $100 so they receive a $250 certificate
If your primary nominated organization has already reached the maximum support level, may we apply your top-up to a second organization?*

YesNo
If yes, please provide the name of your second-choice non-profit organization.
How would you like to pay your $100 top-up?

Invoice my businessPay now by credit card (enter info below)
Would you like your business to be publicly acknowledged as a contributing supporter?*

YesNo
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$100 Top-Up ContributionContribute $100 to increase the support certificate to $250 for your nominated organization.
$100.00CAD Quantity

Total

$0.00CAD
Certificates are redeemable for Chamber Supply Co. products only and have no cash value. Each nominated organization may receive a maximum of two certificates per cycle, and if your primary nomination reaches this limit, your top-up may be applied to your second-choice organization. Chamber Supply Co. may verify that nominated organizations provide charitable, youth, or community-support services. This program is offered at our discretion and may be adjusted based on the number of nominations received.

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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