Apply For Funds Date Of Application: * Granting Region:: * --Select--CalgaryDurhamRegionGTAOttawa First Name: * Last Name: * Date of Birth: * Child's Gender:: * --Select--NoneFemaleMale Child's School: * School Board:: * --Select--Calgary Catholic District School BoardCalgary District School BoardDurham Catholic District School BoardDurham District School BoardHamilton-Wentworth Catholic District School BoardHamilton-Wentworth District School BoardKawartha Pine Ridge District School BoardOttawa Catholic District School BoardOttawa District School BoardToronto Catholic District School BoardToronto District School Board Multi Year Grant:: --Select--First Year2nd Year3rd Year4th Year Street: City: * State/Province: * Parents/Gaurdians Name: * Preferred Phone:: --Select--HomeWorkMobileOther Phone: * Preferred Email:: --Select--PersonalWorkAlternate Email: * Are You Receving Child Support:: * --Select--YESNO If So, How Much Support Income: Other Parent/Gaurdians Name: What is Your Household Annual Revenue: * Other Funding Sources:: --Select--NoneJumpstartKid's In Sport Ontario If So, How Much?: Industry: * --None--Aquatics/SwimmingBaseballBasketballBowlingBoxingDanceDodgeBallFitnessFootballGymnasticsHockeyKickballLacrosseMartial ArtsRugbySkatingSoccerTennisUltimate FreezbeVolleyball Sport Club Name: * Requested Sport/Rec Fee: * How Many Weeks Does the Program Run: * Sport/Rec Start Date: * Sport/Rec Activity End Date: * Cheque Payable To: Sport Club Address: * Sport Contact Person: * Sport Club Email: Sport Club Phone: Give Back Region:: * --Select--Durham RegionOttawaCalgaryGTAHamilton/Burlington/Niagara Organization of Choice:: * --Select--Big Brothers, Big Sisters OttawaBig Brothers and Big Sisters of CalgaryBig Brothers Big Sisters of Hamilton and BurlingtonBig Brothers Big Sisters Whitby OshawaBoys and Girls Club DurhamBoys and Girls Club of CalgaryBoys and Girls Club OttawaCAS OttawaChildren’s Aid Foundation of OttawaChristie Lake KidsCommunity Hope MinistriesCommunity Living of Oshawa/ClaringtonDurham Regional Police ServicesFaith Family Church Food BankFeed the Need DurhamGate 3:16 Outreach CentreHabitat for Humanity DurhamHumane Society of Durham RegionJohn Howard SocietyJohn Howard Society OttawaKendalwood Seventh-Day Adventist ChurchLife Point ChurchOther OrganizationOttawa Community Housing AssociationPark Road South Community HomeSeventh Day AdventistSt. Vincent de Paul Society – St. Gertrude’s (Oshawa)St. Vincent de Paul Society – St. Gregory’s (Oshawa)St. Vincent de Paul Society – St. Phillip’s (Oshawa)St. Vincent’s Kitchen (Durham Outlook for the Needy)The RefugeThe Salvation Army: Bowmanville Food BankThe Salvation Army – Ajax (Pickering)The Wynfield LTC DurhamThe Wynfield Retirement DurhamWhitby Rotary ClubWillow Park Co-operative HomesYouth Employment Resource CentreYouth Services BureauYWCA Durham If Other, Where?: Special Considerations: Terms & ConditionsBy Agreeing To te Terms and Conditions You Agree to the Following: 1. The sport/recreation of your choice submitted in this application. 2. To complete your give back within 3 months of receiving funding. 3. Funding will be directed in your childs name to the sport/club or recreation activity chosen in this application. 4. At the discretion of Their Opportunity, funds will be disbursed which maybe include full or part funding. All eligibility is based on funding available. Do You Agree To The Above Terms & Conditions?: * --Select--YESNO Send me a copy * These fields are required.