99 Gorse Street (Upstairs)
PO Box 789
Valemount, BC V0E 2Z0
Phone: 250-566-4601
10:00am - 3:00pm Monday - Thursday
Closed Fridays & Statutory Holidays
Community Refugee Sponsorship 'Call to Action'
Please return to the Valemount Learning Centre by Friday, January 31st 2016
1. I am a(n):
□ Individual or Family □ Community Group (church, non-profit, etc) □ Business
2. Contact Information
Name: ___________________________
Ph. # ___________________________
Email: ___________________________
Mailing Address: __________________________________________________________________
3. I would like to help sponsor a refugee family through:
□ Financial Donation □ One time __________ □ Monthly (for 12 months) _________
□ In-kind donations □ Specific item(s) ______________________________________
□ Item(s) to be determined
□ Volunteering
□ Create a fundraising event: ________________________________________
□ Help with a fundraising event
□ Assist family with part of their integration: _____________________________
(i.e. community orientation, healthcare, accommodation, school, banking/insurance, shopping, food, etc)
□ English language tutor or conversation partner
□ We are a community group with charity status that can open a bank account, collect donations, and issue tax deductible receipts
□ We are a community group that can provide space and coordinate collections of in-kind donations
□ I can provide temporary accommodation when the family arrives if needed until permanent accommodation can be found and prepared
□ I have a suitable accommodation rental that I can offer for subsidized rent
□ Other: ____________________________________ (feel free to be creative!)
4. Confidentiality
□ I consent to being recognized for my contribution
□ I would like my contribution to remain private
5. In-kind donations
In-kind donations are expected to be in good (or new) condition. Examples of in-kind donations that are needed:
• Household items (kitchen/bathroom)
• Furniture (beds, tables, bookshelves, couch, etc)
• Linens (sheets, towels, blankets)
• Winter clothing
• Bicycles
6. Thoughts / Ideas / Questions
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Valemount Learning Centre
Tel: 250 566 4601 Fax: 250 566 4602
Regency Place, 1201 5th Ave, Box 789, Valemount, B.C. V0E 2Z0