Application Form
Please print the following information and either fax or email it to us.
| Organization Name: | ||
| Contact Person: | ||
| Phone Number: | ||
| Fax: | ||
| Email: | ||
| Website: | ||
| What services does your organization provide? | ||
| Who is your target clientele by demographics and / or by location? | ||
| What kind of fundraising do you already have in place? | ||
| When are the funds needed, and how much are you looking to raise? | ||
| If EBC approves your application what would the funds raised through our program be used for? Please give examples. | ||
| Please provide any additional information that you feel is relevant. | ||
Please fax form to 780-454-8774 or email to info@everybeancounts.ca
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