Become An Agency

You can register your agency below by entering your information. Please be advised we are not accepting applications at this time, check for an update in FEBRUARY 2021.

Agency Information
Agency Name*
Chapter Association
Main Contact Name
First Last
Phone*
Website
Agency Address*
Street Address Address Line 2 City Province Postal Code
Qualifying Questions
As the Agency or Organization representative I have read and fully understand the criteria as noted on the Child Criteria page.*
Check out the Child Criteria page.
As the Agency or Organization representative I fully understand that all nominated children for the flight will require a valid Canadian Long Form Birth Certificate.*
As the Agency or Organization representative I understand that any child put forth can not have a parent or legal guardian that works for Air Canada or another airline.*
As the Agency or Organization representative I understand that we will be required to participate in one of the local chapters fundraising events.*
Account Information
Name*
First Last
Email*
User Name*
Password*
Enter Password Confirm Password

Strength indicator
Name
This field is for validation purposes and should be left unchanged.

Become An Agency

Agency Information

Qualifying Questions

Account Information

Dreams Take Flight | Edmonton

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