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Epson Focused Giving Community Relations Program
Focused Giving Community Relations Application
are required fields.
Applicant First Name
Applicant Last Name
Contact Phone Number
Applicant Mailing Address
Alternative Contact First Name
Alternative Contact Last Name
Alternative Contact Phone Number
Alternative Contact Email
Organization Location / City and Province
What type of support are you applying for?
Product and Monetary Funds
Media ex: paper, ink, transfer film, etc
Pro Photo imaging printers
Pro Imaging printers
Home Theatre projectors
Please list the quantity and name of products you are requesting. If you do not know a specific product name, please describe what you are requesting.
Were you referred to this program by an Epson employee?
Who referred you to this program?
What area does your organization serve?
Culture and the Arts
Public Welfare/Support for those in need
If other, please fill in text box stating which area is served
Upload a one-sheet for your organization (PDF)
This may include: description, charter, or mission statement.
Upload a copy of a current Statement of Activities (PDF)
Upload a copy of current Statement of Activities (PDF). A Statement of Activities is one of the main financial statements your organization produces for financial tracking.
Upload your T3010 Registered Charity Information Return document (PDF)
List of Board members including notation of either salary or volunteer status
Target population including size and demographics
Explanation of how your constituency will benefit from the donation
Organizations that have previously received a donation from Epson must also include a statement of how the donation was used by the organization and its impact on the communities it served.