Town of WhitbyWhitby
 
 
 Canadian Tire Jumpstart Application Form   
 This form must be completed after the Access Program Application Form to apply for Canadian Tire Jumpstart Funding. For further questions please call 905.430.4338 or email subsidy@whitby.ca.  

 
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  Request for Funding
   
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* The value must be between 1 and 24, inclusive.
 
   
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* The value must be between 1 and 24, inclusive.
 
   
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Proof of cost of program must be attached- e.g. brochure, letter from organization
 
   
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Mailing Address            
   
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I certify my endorsement of the above child/youth and verify that all the information given is correct and can be substantiated.    
I also give permission to Canadian Tire Jumpstart to contact me if necessary.    
   
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  Personal information on this form is collected under the authority of Section 11 of the Municipal Act, SO 2011, c.25 and will be used for the registration purposes in requesting recreation program(s). Questions regarding the collection of personal information should be directed to the Records Manager, 575 Rossland Road East, Whitby, ON L1N 2M8.
   
 
 
 
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Town of Whitby