First Name
Last Name
Address Line 1
Address Line 2
City
Country
Please select...
Canada
Province
Please select...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Email
Phone Number
Organization
Please provide a description of your fundraising initiative
Launch/Event Start Date
End Date
Where will the fundraiser take place? (Location or Region. If virtual, please indicate.)
How will you promote the initiative?
Fundraising
G
oal
How will funds be raised?
Pledges
Auction
Ticket Sales/Registration
Donations
Sales
Other
Other
Expected number of participants:
Would you like a representative of DWF to attend your fundraiser? (Subject to availability. Travel and accommodation fees will be the responsibility of the third-party fundraiser.)
Yes
No
Have you previously engaged DWF before?
Yes
No
How did you hear about us?
You agree that the Gord Downie & Chanie Wenjack Fund (DWF) may collect, use, and disclose your personal data which you have provided in this form, for the purpose of providing marketing material that you have agreed to receive, in accordance with our Privacy Policy. Please confirm if you would like to receive communication from DWF in the future.
Yes, I would like to receive updates from DWF