Organization name (if applicable):

Contact Name:

Position/Title:

Address:

City:

Province:

Postal Code:

Phone Number work:

Phone Number home:

Phone Number cell:

Fax Number:

Email:

I would like to help out by:

volunteering for a specific event or task

participating on a committee

serving as a Director

other (please specify)

Our organization is willing to donate:

time

services

photocopying, postage, etc

other expertise (please specify)