Member Charity Nomination Form

Please submit this form at least one week prior to the meeting so that we can confirm eligibility of the organization you are bringing forth. Once eligibility is verified, the charity will be added to our list of pre-qualified charities eligible for presentation and funding consideration at a future meeting.

Nominating Member Name *
Nominating Member Name
Nominated Organization Name *
Nominated Organization Name
Contact Person at Nominated Organization *
Contact Person at Nominated Organization
Contact Person's PHone *
Contact Person's PHone
Organization's Street Address *
Organization's Street Address
Yes, This organization is a registered charity with the ability to provide individual tax receipts. *