78 Rolark Dr
Toronto, Ontario M1R 4G2
Charity Number:	89317 5414 RR0001
Phone:	(416) 752-HELP
Fax:	(416) 752-4222
www.ICANhelps.com

Centre Name:

Contact Person:

Registration #:

Address:

City:

Province:

Postal Code:

Phone:

Fax:

Email:

Type of Organization:

Camp
Church
Day Care
Food Bank
Foster Home
Hospital
Pantry
Relief Mission
School
Shelter
Soup Kitchen
Youth Program
Other

Estimated number of
people served by your
organization:

Please outline what
your organization does:

Please ensure you have provided all required information

Fee for new members: $50.00

Terms & Conditions

I understand that as a member of ICAN. that our organization is entitled to all the benefits of being a member of the Association.

It is understood that the community as a whole has a responsibility to the less fortunate, as well, the recipients of this assistance also have a responsibility to the community they reside.

The food and other products procured through ICAN. are to be used for the express purpose of assisting the community through its members.

As a member of the ICAN. we are entitled to vote on the committees that represent this Association for New Members and Donations.

That our Organization is entitled to place orders for products as needed and that a fax list of available products can be sent when needed.

As a member of ICAN. we are entitled to promote the association to all potential donors and recipients at all times.

As a member we are required to pay our membership dues each year, to continue to participate in the programs offered.