Stix n Pix Sponsorship Support Application (Stix n Pix)

Print Stix n Pix Sponsorship Support Application

Stix n Pix is offering the opportunity for funding for up to 5,000.00 for either an individual or group who will enroll and/or run program(s) for Norfolk youth in either music of hockey. Existing programs can apply along with new programs. Please complete Application - Submit Form at end, email confirmation will be sent to applicant. Any questions please contact Elaine Thomas - [email protected]

Applicant Information

Please complete section - any questions contact Elaine Thomas - [email protected]

Applicants Name^*

Full name of person or Group
Contact Name

for a Group Application
Applicant Address^*
Applicant City/Town^*
Applicant Postal Code^*
Applicant Phone Number^*

Example: ###-###-####
Applicant Cell Phone Number^*

Example: ###-###-####
Applicant Email address^*

confirmation of application received will go to this email address.
Child's Name

if application is for a Child

Information on reason for applying

Please complete section

Did your child Participate in First Shift Program
YESNO
provided by Norfolk County & Stix n Pix
Nature of Funding ^*

e.g. equipment, registration, team wear, financial please provide details
Total Cost of Equipment requested^*

e.g. sport, music specific equipment
Amount (or approximate cost) of funding support requested^*
Please provide a brief story outlining how this need came to be.^*

Yes, I am willing to assist Stix ‘n’ Pix in its ongoing fundraising activities in support of grassroots hockey participation.

Yes I will
Yes, I am willing to submit photos and a descriptive write up of my child’s participation in the sponsored activity for use on the Stix ‘n’ Pix website.

I agree to the terms and conditions stated above
**Note: Additional information may be required depending on the amount of support being requested.

I agree to provide additional information if required^*
By clicking on the Submit Form button - your are acknowledging that you are the Applicant for completing this form, and it will be recognized by Stix n Pix as your signature.

I agree to the terms and conditions stated above^*

Human Validation

Check The Box ^*

Stix n Pix Sponsorship Support Application (Stix n Pix)

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