Third-Party Affiliation Request Form

"*" indicates required fields

If you require this form in an alternative format, please contact Adam Mohammed, Web Developer.

Club Name

Your Name

Executive Position

Your position in the club, i.e. president

Campus

Company Name

Contact Name

Position at Sponsoring Organization

Contact person's job title.

Street Address*

Address Line 2

City*

State / Province / Region*

ZIP / Postal Code*

Country*

Phone

Website

Why do you feel this third party affiliation is necessary?

How will this affiliation benefit the Humber and Guelph-Humber community?

What type of support are expecting from the third party?

Comments

This field is for validation purposes and should be left unchanged.