Document

APPLICANT INFORMATION

First Name*

Last Name*

Email Address*

Address*

City*

Province/State*

Country*

Postal Code*

Phone Number*

ORGANIZATION INFORMATION

Organization Name*

Registered Charity Number*

EVENT NAME

Event Name*

Purpose of Event*

*maximum limit of 500 characters

Event Location Name*

Event Address*

Event City*

Event Province/State*

Event Country*

Event Postal Code*

Event Date* (mm/dd/yyyy)

Additional Comments*