Application Form

Required fields are indicated by an asterisk (*).

*Program Category: Please select Educational Initiative Arts and Culture Health and Human Services Product Donation

*Legal Name of Organization

*Registered Charity Number:

*Has your organization requested a donation from 3M within the last calender year? Yes No

*Street Address:

*City:

*Province: Please Select Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon

*Postal Code:

*Name of Contact Person:

*Title of Contact Person:

*Telephone Number:

Fax Number:

*Email Address:

Monetary Request: (Amount needed and how you think this request fits with our current Corporate giving strategy)

Product Donation: Quantity and where/what product will be used for.

Program Title and Brief Description:

The information you submit will be kept and used by 3M Canada Customer Service to respond to your request. For further information on how 3M respects your privacy, visit our Privacy Policy and Privacy Code.

I consent to such use by 3M Canada.