Local 2036 Request for Charitable Funds
The following is to be Completed by the Member
Please provide your email below so we can respond to your request appropriately:
*
Date of Request :
*
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Month
-
Day
Year
Date
Date of Event:
*
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Month
-
Day
Year
Date
Name of Member(s) Requesting Donation:
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Please provide event information (I.e. Name of event, organization or charity):
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Charity Registration Number (if applicable):
Type of Donation
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Individual $500
Team $1000
Other Amount
If you selected the "other amount" option above, please specify if it is an individual or team request:
Individual Request
Team Request
Other Amount Specified:
Please specify who to make the cheque payable to OR provide a donation link:
*
If there are any other details or questions please provide them below:
The following is to be completed by the Charitable Committee and Executive Board
Previous year’s 4 hours completed?
Yes
No
Approved by all 4 members of the Charitable Committee?
Yes
No
Approved by The Executive Board?
Yes
No
Charitable Committee Chair Approval Signature:
Adrian Award
Executive Board Treasurer's Approval Signature:
Jason Swail
Submit
Should be Empty: