REQUEST FOR DONATION
 
For Corporate Sponsorship requests, click here
 
 
Registered Charity Number:
 
 
Name of Organization:
 
 
Address 1:
 
Address 2:
 
City:
Province:
Postal Code:
 
Contact Name:

 
Email Address:
 
 
 
Title:
Telephone:
 
Website Address:
Social media:
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Budget:
Admin Cost: %
 
Donation Type:
 
Monetary:
Product (please specify):
 
Donation required by (Date):
 
Mission/ Purpose of the Organization:
 
Describe how the donation will be used and the anticipated outcomes/benefits:
 
Scope:
 
Have you received support from Panasonic in the past:
 
If yes, please describe:
 
Comments or additional information:
 
Please attach any supporting documentation:
 
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By filling out and submitting this form, I am providing my consent to Panasonic Canada Inc. to collect my personal information for donation purposes. I understand that I can withdraw my application at any time.