Donation Application Form

Information about the applicant:

Title *

Mr.

Mrs.

Last name *

First name *

Email *

Telephone *

Name of the organization *

Address *

Website

Mission of the organization

CRA Registration Number

Organization’s administrative overhead (%)

Have you already received financial assistance from PMT ROY Foundation or Ellipse Foundation? *

Yes

If yes, in which year?

Information about the application:

Cause, campaign, event or project

Time period

Number of people who benefit

Amount requested

Cheque made out to

How do you plan to report to the Foundation?

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