Application for a Charity permit

Important: Please consult the document “Instruction Sheet: Applying for a Charity Permit under the Migratory Birds Regulations, 2022” when filling out this application. Incomplete, illegible or unsigned application forms will be returned and may result in a refusal of your application or a delay in the issuance of your permit. Send the completed application form and any additional documents to your regional Canadian Wildlife Service office (contact information can be found in Annex A on the accompanying instruction sheet).

For the purpose of this application, “birds” are defined as migratory game birds or murres.

Section 1. Applicant information

1.1 Previous permits

Do you currently have or have you previously held a charity permit in Canada?
Yes [Checkbox]
No [Checkbox]

If yes, provide the most recent permit number:

Have you ever been refused a charity permit or had one cancelled or suspended?
Yes [Checkbox]
No [Checkbox]
(If yes, provide reason):

Have you ever been convicted of an offence under the Migratory Birds Convention Act or the Migratory Birds Regulations, 2022?
Yes [Checkbox]
No [Checkbox]
(If yes, provide reason):

1.2 Primary contact information of applicant

Surname:
Given name:
Position/Title (e.g. Director of Outreach), if applicable:
Mailing Address (street number and name, incl. P.O. Box if applicable):
City:
Province/Territory:
Postal Code:
Telephone Number (day):
Telephone Number (other):
Email Address:
Fax (if applicable):

1.3 Charitable organization information (If applicable)

Name of charitable organization:
Mailing Address (street number and name, incl. P.O. Box if applicable):
City:
Province/Territory:
Postal Code:

Is the organization a registered charity?
Yes [Checkbox]
No [Checkbox]
(indicate registration number):
Registration number of registered charity:
Mandate/Statement of purpose of organization:

1.4 Nominees [Annex 1 – additional lines]

Name:
Name of organization:
Position/Title:

Section 2. Charitable cause information

2.1 Activities to be conducted

Select all activities that will apply to this permit:

serving preserved birds at a charitable fundraising event [Checkbox]
serving preserved birds at a soup kitchen [Checkbox]
giving preserved birds to clients of a food bank [Checkbox]

2.2 Activity description

Describe the purpose of the activity indicated in section 2.1:

Will this activity produce any profit?
[Checkbox] Yes
[Checkbox] No

If “Yes,” please explain how the profit that is made will be used to protect or conserve migratory birds or other wildlife:

2.3 Anticipated activity duration

Complete

For soup kitchen or food bank or for a single fundraising event

Soup kitchen or food bank

Start Date (YYYY/MM/DD):
End Date (YYYY/MM/DD):

Single fundraising event

Start date of fundraising event 
(YYYY/MM/DD):

End date of fundraising event:
(YYYY/MM/DD):

Start date of period for accepting birds 
(YYYY/MM/DD):

End date of period for accepting birds 
(YYYY/MM/DD):

2.4 Activity location address

Please indicate the legal address of the location(s) where the permitted activities will occur. [Annex 2 – additional lines]

Location 1

Check all activities that will apply to the designated location

[Checkbox]  Birds will be accepted
[Checkbox]  Birds will be stored
[Checkbox]  Birds will be given to clients of a foodbank
[Checkbox]  Birds will be served as a meal at a soup kitchen
[Checkbox]  Birds will be served as a meal at a fundraiser

Street Name and Civic Number:
City:
Province/Territory:
Postal Code:

Location 2

Check all activities that apply to the designated location

[Checkbox]  Birds will be accepted
[Checkbox]  Birds will be stored
[Checkbox]  Birds will be given to clients of a foodbank
[Checkbox]  Birds will be served as a meal at a soup kitchen
[Checkbox]  Birds will be served as a meal at a fundraiser

Street Name and civic number:
City:
Province/Territory:
Postal Code:

Section 3. Statement of certification and applicant signature

I, [print full name] attest that I have the knowledge to conduct the above activities and certify that:

• all information submitted in this application is accurate and has been completed to the best of my knowledge;
• the nominees (if applicable) have the knowledge to conduct the permitted activities;
• I will submit a report by the date indicated on the permit;
• I agree to an inspection of the premises if one is required;
• I may not commence any activities that are the subject matter of this application before a valid charity permit is in my possession; and,
• I understand that in order to legally conduct the activities I may need to obtain additional federal, provincial, territorial, municipal or other permits or authorizations (e.g., food safety laws and regulations).

Signature of applicant:
(sign with dark ink)

Date:
(yyyy/mm/dd)

For internal use only

Date received:
Permits Officer:
Approved [Checkbox]
Refused [Checkbox]
Date (YYYY/MM/DD):

Previous report on file
Yes [Checkbox]
No [Checkbox]
NA [Checkbox]

Documentation missing
Yes [Checkbox]
No [Checkbox]

Comments:

Annex 1.

1.4.1 Additional nominees (If applicable)

Name:
Name of Organization:
Position/Title

Annex 2.

2.4.1 Additional activity location address (If applicable)

Please indicate the legal address of the location(s) where the permitted activities will occur.

Location 3 (If applicable)

Check all activities that apply to the designated location

[Checkbox]  Birds will be accepted
[Checkbox]  Birds will be stored
[Checkbox]  Birds will be given to clients of a foodbank
[Checkbox]  Birds will be served as a meal at a soup kitchen
[Checkbox]  Birds will be served as a meal at a fundraiser

Street Name and civic number:
City:
Province/Territory:
Postal Code:

Location 4 (If applicable)

Check all activities that apply to the designated location

[Checkbox]  Birds will be accepted
[Checkbox]  Birds will be stored
[Checkbox]  Birds will be given to clients of a foodbank
[Checkbox]  Birds will be served as a meal at a soup kitchen
[Checkbox]  Birds will be served as a meal at a fundraiser

Street Name and civic number:
City:
Province/Territory:
Postal Code:

Location 5 (If applicable)

Check all activities that apply to the designated location

[Checkbox]  Birds will be accepted
[Checkbox]  Birds will be stored
[Checkbox]  Birds will be given to clients of a foodbank
[Checkbox]  Birds will be served as a meal at a soup kitchen
[Checkbox]  Birds will be served as a meal at a fundraiser

Street Name and civic number:
City:
Province/Territory:
Postal Code:

Location 6 (If applicable)

Check all activities that apply to the designated location

[Checkbox]  Birds will be accepted
[Checkbox]  Birds will be stored
[Checkbox]  Birds will be given to clients of a foodbank
[Checkbox]  Birds will be served as a meal at a soup kitchen
[Checkbox]  Birds will be served as a meal at a fundraiser

Street Name and civic number:
City:
Province/Territory:
Postal Code: