Application for sponsorship

1 - Organization information

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> Fields marked with an asterisk (*) are required.

Organization name:
*
Organization goals or activities:
*
Is this a non-profit organization?
*
Yes No
Name of person in charge:
*

Organization address:
No. and street:
*
City:
*
Province:
*
Postal code:
*
Telephone:
*
( ) - Ext.
Fax:
 
( ) -
E-mail address:
 

2 - Sponsorship details

Amount requested:
*
$
Why should the caisse agree to sponsor your organization?
*
Applicant name (if other than person in charge):
 

Applicant address (if different than organization address):
No. and street:
 
Apt.:
 
City:
 
Province:
 
Postal code:
 
Telephone:
 
( ) - Ext.
Fax:
 
( ) -
E-mail address:
 

Please indicate the transit number of the caisse to which you would like to forward the application:
Institution no. (province in which caisse is located):
*
Transit no. (Identification):
*