Non-Profit Organization (NPO) Recognition Form

Form to be Recognized as a Non-Profit Organization (NPO)

*Knowingly providing false information on this form may result in the cancellation and withdrawal of any form of support from the City of Clarence-Rockland.

Organization Name :

Contact Person :

Title/Position within the Organization :

Phone number :

Email :

Country

What types of services are offered by your organization?

Is your organization recognized as a registered charity by the government?

Yes

Please upload the required documents :

One file only.
512 MB limit.
Allowed types: pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif.

Number of years in operation :

Please describe your organization in detail (e.g., mandate, mission, responsibilities, etc.) :

Please describe the type of event you are organizing, if applicable (e.g., frequency, target audience, etc.) :

Please describe how recognition as a Non-Profit Organization (NPO) will help you achieve your goals or mission :

What forms of support will be most helpful to your organization?

Preferential rental rates

Equipment loan

Technical support

Financial support

The organization or group agrees to:

Notify the City of Clarence-Rockland if any changes are made to the information provided above (e.g., office, address, etc.) or if the organization or group ceases its activities;
Use the benefits offered as an NPO to provide service to the community;
Not use the support provided by the City exclusively for the benefit of the organization's members;
Submit financial activity reports to the City of Clarence-Rockland regarding the form of support received;
Display the City of Clarence-Rockland logo on all promotional material related to activities for which support has been received.

I am authorized to act on behalf of the organization and confirm that the information on this form is complete and accurate.

Applicant’s Signature :

Signature ci-dessus

Date of Signature :