DiversityCanada Foundation

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Organization Registration
Signup Form

Required Fields are Marked with *
Contact Information:

*First Name:
*Last Name:
*Phone(000-000-0000):
E-mail(example@diversitycanda.org):
*Street Address:
*City:
*Postal Code:
Best way to contact you:


*Name of Organization:

Address of Organization:
Street Address:
City:
Postal Code:

Website:

Primary Contact:
*Name:
*Position:
*Phone(000-000-0000):
E-mail(example@diversitycanda.org):


Alternate Contact:
Name:
Position:
Phone(000-000-0000):
E-mail(example@diversitycanda.org):

*Description of Organization:
How volunteers can help:
Skills that are required:
When volunteers are needed:
How many volunteers are needed:

Desired Username and Password:
Note: Username and Password are case sensitive
*Username:
*Password: