Community Project Fund Request Form

Project/Activity Request Title*

Title of the Community Project Fund Project

Is this request for our Community Project Fund?*

If YES, you MUST attach the proper application forms, found on the Donation Website

Yes

No

Tell us a bit about your Project/Activity*

Website

Requested By (Name)*

Requested By (Email)*

Requested By (Phone Number)*

Phone

Are you a Centerra Employee?*

Yes

No

Amount Requested*

Multi Year?*

Multi-year funding requests will require further discussion with the Centerra team

Yes

No

Date Requested*

Date of Project/Activity*

Has Centerra Contributed in the Past?*

Yes

No

Brand visibility opportunities for Centerra?*

i.e. Logo placement, Sponsor recognition, Banners, etc.

Additional Information you would like us to know?

File Upload*

Community Project Fund Applicants: Please include a PDF copy of your Community Project Fund application and budget.

Drag and drop files here or

Send me a copy of my responses