FUNDRAISING PROGRAM

Our Fundraising Program aims to assist us with purchasing devices for individuals with disabilities and medical conditions. We do not receive funding or any subsidy from the government and strictly rely on the public and local businesses for our fundraising campaigns.

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Name *

First

Last

Email: *

Email (Type in email 2nd time to make sure it is correct): *

Street Address: *

Street address is required for your final documentation.

Apartment Number if any: *

Apartment number is required for your final documentation. Enter N/A if not applicable.

City: *

City required for your final documentation.

Postal Code: *

Postal Code required for your final documentation.

Type of Volunteer: *

Please enter if you are high school student, court-ordered volunteer or general volunteer

Lawyer Name (Court-ordered only) *

Type N/A if not applicable.

Name of High School: *

Type N/A if not a student.

Age: *

Type N/A if not a student.

Gender: *

Required for documentation.

How many hours do you need to complete? *

Required for documentation.

Deadline(s) for your hours to be completed by: Please enter date *

DD/MM/YYYY format

How did you hear about this volunteer opportunity? *

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