Expression of Interest Form

Company Name

Industry IndustryAgriculture, Forestry, Fishing and HuntingMining, Quarrying, and Oil & GasUtilitiesConstructionManufacturingWholesale TradeRetail TradeTransportation & WarehousingInformation & Cultural IndustriesFinance & InsuranceReal Estate & Rental & LeasingProfessional, Scientific & Technical ServicesManagement of Companies & EnterprisesAdministrative & Support ServicesEducational ServicesHealth Care & Social AssistanceArts, Entertainment & RecreationAccommodation & Food ServicesOther Services (except Public Administration)Public Administration

Where is your company primarily based? Where is your company primarily based?CanadaGlobal with Canadian operations

Your Name: First Name, Last Name

Title TitleMrs.Ms.Dr.

Select the role closest to your responsibilities. Select the role closest to your responsibilities.CSR / ESG / SustainabilityCommunity Investment / Social ImpactCorporate Affairs / Public AffairsCorporate FoundationFinance / ReportingExecutive LeadershipOther

Work Email

What interests you about participating? (select all that apply) What interests you about participating? (select all that apply) National visibility for our community investment work Benchmarking and insights Contributing to a Canada-wide impact initiative Learning and improving our approach Other (short text)

Do you currently track community investment? Do you currently track community investment?YesNoIn progress

Do you publicly report any of this information? Do you publicly report any of this information?YesNoPlanning to

What types of contributions do you make? (check all that apply) What types of contributions do you make? (check all that apply) Cash In-kind Employee volunteering Program /Management costs

Could you provide data for the most recent year if needed? Could you provide data for the most recent year if needed?YesPossibly (need support)Not yet

We are interested in participating in the Niska Community Investment Registry and are open to discussing our participation, including sharing relevant community investment information publicly. We are interested in participating in the Niska Community Investment Registry and are open to discussing our participation, including sharing relevant community investment information publicly. I agree