Charity Prequalification Form

Nominating member: * Nominating member email: * Name of organization/charity * Organization's website: * Charitable registration number: * Contact person's name: * Contact person's phone: * Contact person's Email: *

Annual budget, administrative costs, and other pertinent financial information: * The organization serves the following population: * The donated funds would be used to: * The organization's current sources for funding are: * If selected, cheques should be made payable to: *