Step 1 of 6 16% Contact Information Full Legal Organization Name:(Required)Address: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Website:Name of Applicant: First Last Role Within Organization:(Required)Phone:(Required)Email:(Required) Organization Information Are you a Registered Charity?(Required) Yes No Please provide your charity registration number:(Required)Brief Description of Organization:(Required)How does your request align with the three pillars of impact of our committee? (i.e. youth, education, and underserved communities):(Required) Proposal Request Requested Amount:(Required)How does your request align with the three pillars of impact of our committee? (i.e. youth, education, and underserved communities):(Required)Brief description of initiative, project or event:(Required)Provide an estimated breakdown of how our contribution will make a difference to your organization:(Required)Geographic Area Served:(Required)Request Timeline: e.g. Is there a specific date of an event, is this an annual sponsorship and/or partnership or a major event?(Required)Direct and Indirect Beneficiaries of the Program: (include number of beneficiaries, social and economic status etc.)(Required)Additional Request Details: e.g. We are requesting a national sponsorship but are open to other sponsorship options(Required) Collaborative Approach If the request comes in mid-way through our budget year - can the cost be pro-rated accordingly by your organization?(Required) Yes No Our firm members enjoy getting involved with our community partners at a grassroots level. Please list opportunities for Alexander Holburn staff and lawyers to get involved in a meaningful way with your organization.(Required) Collaborative Marketing Throughout the year we try to find opportunities to promote the groups with which we work. For instance, we publicly acknowledge our sponsors on our annual Christmas Card, and we use our social media and digital channels to showcase the great work our partners are doing. We are open to new and creative ways our teams can work together and share the great work we’re able to do as partners. How will this partnership be promoted by your organization?(Required)What opportunities are there to co-market or cross-promote & what opportunities or parameters are in place in this regard?(Required)Does your organization have an active social media presence? If so, are there opportunities to cross-promote our relationship?(Required)How can we support your mandate via our own channels?(Required) Collaborative Marketing Throughout the year we try to find opportunities to promote the groups with which we work. For instance, we publicly acknowledge our sponsors on our annual Christmas Card, and we use our social media and digital channels to showcase the great work our partners are doing. We are open to new and creative ways our teams can work together and share the great work we’re able to do as partners.Please provide any additional information you feel may assist our committee as they consider community partners.Please upload any additional documentation you feel may help us in making a determination regarding your grant application.Max. file size: 50 MB.Consent By submitting this form, you are consenting to receive marketing emails from: Alexander Holburn Beaudin + Lang LLP, 2700 - 700 West Georgia Street, Vancouver, British Columbia, V7Y1B8, CA, http://www.ahbl.ca. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact.NameThis field is for validation purposes and should be left unchanged. Δ
