Corporate Giving Program – Application for Secondary School Bursary

    Thank you for your interest in our Corporate Giving Program for your Secondary School Bursary, please tell us a bit about you.

    Section A: Information about your organization

    Section B: Information about you (Contact details)

    Section C: Agreement

    By submitting this application I confirm that I have the authority to submit this request and agree to the conditions described below.

    a) All information contained herein is true and accurate to the best of my knowledge;

    b) Should Elexicon agree to provide support for the initiative proposed in this application, I agree that information about this initiative may be used in the promotion of Elexicon’s corporate giving program;

    c) I consent to receiving email notifications regarding this request and any subsequent emails from Elexicon that relate to this request or any future grants or sponsorships associated with this initiative.

    * A separate Gift Agreement, Terms and Conditions will be required to be signed off once the application has been approved and prior to release of funds. This will be provided by Elexicon upon approval of your application.