APPLICATION FORM

Type of application (select) : Type of application (select) : Community Development Fund (CDF)* *

These projects unite different stakeholders around a common goal that will have a lasting impact on the education sector and its sustainable development. If you are submitting a CDF application, select your project's investment priority These projects unite different stakeholders around a common goal that will have a lasting impact on the education sector and its sustainable development. If you are submitting a CDF application, select your project's investment priorityStudent success and perseverancePromoting careers in educationMental health of education professionals

Sponsorship* Sponsorship* Fonds d’aide au développement du milieu (FADM) *

Donation *

Before completing this form, you must read and agree with the following statements: Before completing this form, you must read and agree with the following statements: I have read the Caisse Desjardins de l’Éducation Investment Policy, available at www.caisseeducation.ca/engagement. * If my application is incomplete, I acknowledge that it will not be analyzed and that it will be returned to me. The application will need to be submitted again and processed only when all required documents have been received. *

Name of the organization *

Full address *

Website *

Applicant's name and position *

Phone number *

Email address *

Organization's mission *

Number of members *

Is the organization a member of Caisse Desjardins de l’Éducation? * Is the organization a member of Caisse Desjardins de l’Éducation? *YesNo, belongs to another Desjardins caisseNo, belongs to another financial institution

Project name *

Description *

Expected benefits *

Important dates *

Location *

Target group *

Number of people impacted or involved *

Are other partners involved in the project? * Are other partners involved in the project? *YesNo

If yes, name partners: *

Will the caisse be the exclusive financial institution for the project? * Will the caisse be the exclusive financial institution for the project? *YesNo

If no, name other financial institutions: *

How does your project contribute to the sustainable development of the education sector? Indicate the positive social, economic and environmental impact and how you plan to minimize any possible negative impact. *

Total cost * ($)

Amount of funding requested from the caisse * ($)

What will the funding be used for? *

Are you receiving funding from other sources? * Are you receiving funding from other sources? *YesNo

If yes, please specify: * If yes, please specify: *OuiNon

In the past 12 months, have you submitted this project to other Desjardins Group caisses or entities (like the Desjardins Foundation)? * In the past 12 months, have you submitted this project to other Desjardins Group caisses or entities (like the Desjardins Foundation)? *YesNo

If yes, please specify: * If yes, please specify: *OuiNon

Why should the caisse support your project? *

Considering that the caisse is focused on growing its business with as many education professionals as possible, what kind of visibility can you offer the caisse in exchange for its financial contribution? *

Other visibility opportunities: * Other visibility opportunities: * Caisse representative will speak at your event Social media posts and/or newsletters Messages directly to your members Advertisements in your promotional materials Caisse logo and link on your website Media coverage Caisse can give a presentation to the project's target group Other

The caisse may request additional information such as a detailed budget or visibility plan. The caisse may request additional information such as a detailed budget or visibility plan. I declare that the information provided on this form is accurate and that I am authorized by the organization to submit this application. *

Your mail *

Date *