Date: Society Number: APPLICANT INFORMATION Name of Organization: 1) Contact Person: 2) Position: Mailing Address: Fax: Email: Website: Please list our organization on the PRRD website as a Community Group” Yes No (please check one) “Local Purpose of your organization & description of the types of activities your organization is involved in. 3) If applicable, does your organization own any facilities or properties? 4) Yes No (please check one) Please give the 9-1-1 address and legal description of the property that your organization eithers leases or owns. Executives of Your Organization: 5) President/Chair Name: Phone: Email: Vice President/Vice Chair Name: Phone: Email: Treasurer Name: Phone: Email: Secretary Name: Phone: Email: 6) Please provide a 5 year action plan for your organization. Year 1: Year 2: Year 3:
Date: Society Number: APPLICANT INFORMATION 1) Name of Organization: 2) Contact Person: Position: Mailing Address: Fax: Email: Website: Please list our organization on the PRRD website as a “Local Community Group” Yes No (please check one) 3) Purpose of your organization & description of the types of activities your organization is involved in. 4) If applicable, does your organization own any facilities or properties? Yes No (please check one) Please give the 9-1-1 address and legal description of the property that your organization eithers leases or owns. 5) Executives of Your Organization: President/Chair Name: Phone: Email: Vice President/Vice Chair Name: Phone: Email: Treasurer Name: Phone: Email: Secretary Name: Phone: Email: 6) Please provide a 5 year action plan for your organization. Year 1: Year 2: Year 3: