One on One Form // INTEGRALORG

A clinic is a free, 1-hour, one-on-one problem-solving session about a specific issue of concern to your nonprofit or charity.

If you have a question or issue - about governance, strategic planning, charitable registration – or any other issue that is top of mind for your nonprofit, a clinic may be right for you.

Please fill out the form below and provide as many of the details and documents as possible. If you are not able to fully complete the form or upload all of the documents, that's okay! Our team will review the information and be in touch to set up a clinic.

If you have any questions as you are filling out the form, please call 403-910-7279 or connect by email.

*Name of Organization:

Legal Name of Organization:

*Mailing Address:

*City:

*Postal Code:

*Phone Number:

*E-Mail:

Chair/President:

Executive Director:

Charitable Registration # (if your organization is a charity):

Incorporation # (if applicable):

Jurisdiction of Incorporation:

Primary Contact

*First Name:

Last Name

Phone Number:

Email:

What objects was your organization incorporated to meet?

How did you find out about this clinic?

What is the issue your organization needs help with?

Please upload the following documents if you have them handy. If not, give us a call at 403-910-7279 to find out which documents are definitely required to help us address your question. The clinic team will review your documents in advance of the clinic. NOTE: Clinic volunteers do not provide ongoing professional assistance. Your request must be for a specific issue or question that you have at this time.

Attachments - upload attachments below

Attachment - Board of Directors

Drag 'n Drop Your File Here

Attachment - Cert. of Incorporation

Drag 'n Drop Your File Here

Attachment - Financial Statements

Drag 'n Drop Your File Here

Attachment - Current Budget

Drag 'n Drop Your File Here

Attachment - Bylaws/Articles of Assoc.

Drag 'n Drop Your File Here

Attachment—Strategic Plan

Drag 'n Drop Your File Here

Attachment—Annual Report

Drag 'n Drop Your File Here

How is your organization incorporated? Please upload the relevant documents:

1. (Societies Act) Application (and any amendments) and most recent bylaws filed at Alberta Corporate Registry

Drag 'n Drop Your File Here

2. (CNAC-Canada Not-for-profit Corporations Act) Articles of Incorporation (and any amendments) and most recent bylaws filed at Industry Canada

Drag 'n Drop Your File Here

3. (Companies Act) Memorandum of Association (and any amendments) and most Articles of Association filed at Alberta Corporate Registry

Drag 'n Drop Your File Here

Terms & Conditions

This document sets out the standard terms and conditions for nonprofits and charities applying to the Clinic. By signing and returning this application form, you agree to be bound by these terms and conditions, unless there are express variations or exclusions given in writing.

Application for Assistance

1. The Clinic Coordinator reviews all applications and can decline your application. 2. No ongoing professional relationship including that of solicitor-client is formed with the Clinic or any of its volunteers, officers or employees by submitting this application or participating in the clinic. 3. Neither the Clinic nor any of its volunteers, officers or employees has any duty to look after your legal interests or those of your organization.

Confidentiality

4. Information provided to the Clinic Coordinator by applicants and parties on your behalf is confidential, with the exception that it is shared with volunteer professionals. 5. Any verbal information or information set out in this application or any other form or document that you provide to, or is prepared by, the Clinic or a volunteer professional can be: • stored at the Clinic office; • reviewed by staff members of the Clinic, its employees, designates, and volunteers; • photocopied; • typed, scanned, transcribed, and stored in a computer system; and • uploaded and backed up via the internet to a third party data protection service.

Conflicts of Interest

6. The Clinic Coordinator may send all or part of the information listed your application to a volunteer professional to determine if they can assist you. 7. The volunteer professional cannot assist you if a conflict of interest is discovered or arises and makes it inappropriate for the volunteer professional to continue to provide assistance. 8. The volunteer professional is free to act for other clients against you on other unrelated matters in the future, without notice to you.

Right to Retain Documents

9. Any documents that form part of your file may be kept by the Clinic and used for the following reasons: • Administrative record keeping; • Maintaining a database of organizations served; • Conducting conflict of interest searches; • Assessing the quality of service provided; • Gathering general and anonymous statistics; and • Evaluating types of services utilized;

Consent for Contact

10. You may be contacted by the Clinic organizers to provide feedback about the services provided. If contacted, you may refuse to participate.

Full and Final Release

11. You release and undertake not to make any court-based or other claim against the Clinic, its volunteers, officers or employees or any participating professional firms together with all of their respective officers, employees, and volunteers for any advice/service you received or should have received through the Clinic.

By clicking the check box I agree that I have complete this application form on behalf of my organization, I represent that the information provided is correct to the best of my knowledge and that I have read, understand and agree to be bound by the terms and conditions in this document. [Clicking the check box will be accepted in lieu of a physical signature for this online application].

*Full Name of Applicant Completing This Document

*Date of Application

Note: Eligibility is subject to the approval of the Clinic Coordinator

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