100 Women Who Care Red Deer
Charitable Organization Nomination Form
Date:
Nominating Member’s Name:
Name of Organization you are nominating:
Address:
Website:
Mission Statement:
The organization serves the following population:
The donated funds will be used to:
The organization’s current sources of funding are:
The organization is a registered not-for-profit/charity and is ale to provide tax receipts. YES / NO (If no, see below)
If selected, someone from the organization will be available to speak at our next meeting to describe the impact of the donated funds. YES / NO
The organization agrees not to sell, give away, or use, the 100 Women Who Care Red Deer members’ contact information for solicitations. YES / NO
What percentage of donations is used for administration costs?
If selected, cheques should be made payable to:
*If the organization you are nominating is not a registered charity, please provide the name of the not-for-profit organization that will be sponsoring the organization with their charitable organization number.
Sponsor Name
Sponsor Charitable Registration #: