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







Valemount Learning Centre

Tel: 250 566 4601     Fax: 250 566 4602

Regency Place, 1201 5th Ave, Box 789, Valemount, B.C. V0E 2Z0


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