National Congress of Italian Canadians

National Congress of Italian Canadians
Toronto District

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Online Form

Please fill out the form below and Submit your information by pressing the "Submit" button at the end of the form. One of our members will review your information and contact you with an additional questionnaire to fill out for our records.

CONTACT INFORMATION

Full name of organization:

Acronym of the organization, if applicable (e.g., NCIC-TD, for National Congress of Italian Canadians - Toronto District):

First name of principal contact:

Last name of principal contact:

Relation of principal contact to the organization:

MAILING ADDRESS OF ORGANIZATION

Street Number - Street Name (Please specify 'road', 'street', 'avenue' or whatever else applies):

5. - 6.

Apartment, suite, or unit number (Please specify which):

City:

Province:

first half of postal code - second half of postal code

10. - 11.

Telephone Area code - Telephone number (including extension) of principal contact

12. - 13.

Facsimile Area code - Facsimile number of organization

14. - 15.

E-mail address of organization

URL (website address) of the organization

E-mail address of contact if different from that of the organization:

If it is necessary to send information to the contact person via e-mail attachment, what format do you prefer? (e.g., Lotus Word Pro 96, MS Word for Windows 6.0, WordPerfect 7.x):

E-mail address of alternative contact "a":

E-mail address of alternative contact "b":

ORGANIZATIONAL CATEGORY

(Select one or more of the following categories to describe your organization's character and focus):

22 advocacy		32 media
23 the arts		33 patronato
24 athletics		34 professional association
25 business/commerce		35 religious
26 culture		36 recreation
27 education		37 rehabilitation
28 food/drink		38 seniors
29 health/medicine		39 social
30 hobby		40 social service
31 Italian government agency		41 youth

If the foregoing list of categories does not include one or more organizational categories that you believe apply to your organization, please indicate in one or more of the spaces below the additional category or categories which do apply