Committed to community support during COVID-19

Application form

Organization information

---

Organization name *

Please enter your organization name.

Project name *

Please enter your program name.

Organization website (if applicable)

Please enter your organization website

Organization mailing address *

City or town *

Please enter your city/town.

Province * Alberta

Please select your province.

Postal code *

Please enter your postal code.

Type of organization *

Non-profit

Registered charity

Municipality

First Nation or Métis Settlements

Youth

Other (please specify below)

Contact information

---

Name of key contact person *

Please enter contact person's name.

Job title *

Please enter key contact person's job title.

Phone *

Please enter a valid phone number for contact.

Email *

Please enter a valid contact email address.

Sponsor organization (if your organization is non-registered)

Please enter sponsor organization's name.

Sponsorship organization contact person

Please enter sponsorship contact person's name.

Job title

Please enter sponsorship contact's job title.

Phone

Please enter a valid sponsorship contact phone number.

Email

Please enter a valid sponsorship contact email address.

Expression of need

---

Briefly describe the COVID-19 related needs you are applying for and how this request will effectively address those needs. This information is needed to understand how your organization is addressing the issues and adapting to the shifting needs of your community during this time. *

Please fill out this section to continue.

What target population(s) does this request support?