100 Men Who Care Halton Hills

Charity Nomination Form

Back

Member Full name

Name of Charity

Website of Charity

Address of Charity

Charity Contact Name

Charity Contact Email

Charity Contact Phone

Charity Charitable Number

Charity Mission Statement

How will donated funds be utilized?

Charity's current source of funding?

If the Charity serves areas outside Halton Hills, provide details

Charity is registered and can provide tax receipts to our members.

If choosen, someone from the charity can/will attend next meeting to present how funds are utilized?

Charity agrees not to sell/use Members personal information for solicitations

I agree to terms and conditions outlined in the rules and regulations

Rules and Regulations