Playground Supervision Program - Application form for Neighbourhood Groups

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Name of primary contact person:

Complete Mailing Address:

Postal Code:

Telephone:

Enter a valid phone number. Example: 123-456-7890

Email:

Enter a valid email address. Example: name@company.com

Playground location:

Start date requested:

Finish date requested:

Days per week that you would like your playground staffed:

Hours per day that you would like your playground staffed:

Do you have a potential employee to recommend?

Would you like potential candidates referred from the City database?

Yes

Do you have any requests for physical improvement to your playground? If yes, please complete the maintenance request sheet.

Yes

For all applicants: Please complete the neighbourhood committee registration sheet.

If application is approved, a cheque for the operational grant will be issued. To whom should this be made payable: Name:

Complete Mailing Address:

Postal Code:

Application deadline is the last day of March.