Request to Waive Fees

The Municipality of Port Hope has a request to waive fees policy. Please complete the following form to submit your request.

Applicant Name/Organization Name:

Which of the following best describes your organization?

Registered Non-profit Organization

Community Group

Other

Contact Name:

Phone

Email

Organization Address

What is the purpose of your Application?

If this event or activity have any other funding support, please describe:

Please attach a budget summary for this event.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

What is the date of your activity for which you are requesting?

What is the location of your activity?

Will you charge an admission fee or participation fee for your activity?

Yes

No

Is your activity open to the public?

Yes

No

How many participants are expected?

What is the Fee Amount you are requesting to have waived?

Please explain in detail why waiving of fees is requested:

Date of Application:

Signature of Applicant

Clear

Staff Use Only

Does this application meet the policy?

Yes

No

Have booking and related fees been confirmed through Central Bookings?

Yes

No

Received by (staff name)

Date

Reviewed by (staff name):

Date

Action by staff:

Fee Waiving Approved

Fee Waiving Denied

Referred to Council

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Request to Waive Fees

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