Administrative Questions:

Name of Applicant Organization

Country

If Other, Please Indicate

Charity Registration Number if Applicable

Contact Person (Full Name)

Contact's Title/Position:

Email

Phone Number (Phone Number Including Area Code)

Organization Street Address:

City/Town/Village

Province

State

Province/State

Postal Code/Zip Code

Type of Organization

NGOCommunityGovernment

Please Provide the Mission Statement of your Organization: (150 words max)

Does your organization prioritize inclusive and equitable programs?

We have established plans and policies for this matter and have integrated it into the organization.Our commitment to inclusive and equitable programs is part of our public profile (i.e. on the website)This project will advance inclusive and fair opportunities as part of project goals and objectives.

If you have a policy you can attach it below, if you speak about your commitment to inclusive and equitable programs on your website please URL link here:

Please State the Name of the Project/Event/Other this Application Refers to: (50 Characters - 10 Words Max)

Is this Request for Program Support or Event Sponsorship?

Program SupportEvent SponsorshipFundraising Support

Does your Program Require Cash, In-Kind and/or Volunteer Investment?

CashIn-Kind DonationVolunteers

Is This a One-time or Reoccurring Request?

One-TimeReoccurring

Please Indicate Which Thematic Priority Your Demand Aligns with

Quality EducationHealth & Well-beingResources ProtectionHumanitarian Aid

Is the Event for a Specific Population or Demographic Group, or the General Population?

If Other, Please Describe

When Do you Require a Decision? (MM/DD/YYYY)

Is There Any Other Information you Would Like to Tell Us?

Do you have a sponsorship package and/or a policy prioritizing inclusive and equitable programs you would like to include?

YesNo

If Yes, Please Attach

Program Funding

Please Describe the Program you Are Seeking Funding for? (75 words max)

Event Sponsorship

Please Describe the Event you Are Seeking Funding for (25 Words Max)

If you Are Seeking Event Sponsorship, Please Share the Primary Purpose of the Event

If Other, Please Describe (50 Words Max)

Please Estimate the Number of People to Be in Attendance?

Financial Support

Please Indicate the Amount of Financial Support You Are Seeking (in Number Format)

Please Share the Total Program Budget (in Number Format)?

How Many Years of Support Are you Seeking

1 year2 years3 or more years

Have you Already Secured Other Investment?

YesNo

If Yes, How Close Are you to Your Goal (10%, 25%, 50% Etc.)

In-Kind Donation

What Type of Product are You Seeking?

ClothingDisaster relief basic itemsOther

Please Describe Required Items, and Quantity (Max 100 Words)

If you Are Requesting Apparel, Please Specify Which Style(s), Colour(s) and Size(s) (Max 100 Words)

Please Estimate the Number of People to Be Impacted

Volunteering Request

Please Describe the Type of Request for our Volunteers:

Number of Volunteers Requested

Recognition

Will you Recognize Our Support

YesNo

How Will you Recognize Our Support?