Endowment 150 Child Application

Age 0-17

Endowment 150 offers eligible people with disabilities a one-time grant of $150 to help their Registered Disability Savings Plan (RDSP) grow. If eligible, this $150 deposit will attract up to $450 in government grants, for a total of $600 into your RDSP.

PLEASE COMPLETE THE APPLICATION IN FULL. ANY MISSING SECTIONS WILL RESULT IN A DELAY IN PROCESSING YOUR GRANT.

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* 1. Beneficiary Name

First Name

Last Name

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* 2. Beneficiary Information

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address

Phone Number *

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* 3. Beneficiary Date of Birth - Must be 17 years or under (DD/MM/YYYY)

Date / Time

Date

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* 4. Holder Name

First Name

Last Name

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* 5. Holder Information

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address

Phone Number *

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* 6. Relationship to Beneficiary (e.g. Legal Parent, Guardian, etc.)

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* 7. Financial Institution where RDSP is held

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* 8. Grants are normally issued by cheque. If you would prefer to receive your grant payment by Electronic Fund Transfer (EFT), please attach a void cheque or a Direct Deposit Form here. (Please note we require an email address to process EFT payments)

PDF, JPG, JPEG file types only.

Choose File

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* 9. Please attach a copy of your RDSP statement or official bank/government document clearly showing the:
- RDSP holder’s name
- The date which is within the last six months
- The term "RDSP" or "Registered Disability Savings Plan"

PLEASE MAKE SURE YOUR RDSP STATEMENT HAS THE ABOVE COMPONENTS. ANY MISSING INFORMATION WILL RESULT IN A DELAY IN PROCESSING YOUR APPLICATION. Application forms are not considered proof of your RDSP account.

PDF, JPG, JPEG file types only.

Choose File

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* 10. Disclosure: Please read carefully, and check EACH item to indicate your consent.

I certify that the information provided in this application is true, correct and complete to the best of my ability.

I certify that I have never received the E150 from any organization previously to the best of my knowledge.

I certify that upon receipt of the E150, I will deposit it into the RDSP account listed on my RDSP statement.

For auditing purposes, I understand I may be required to provide proof of this deposit to Plan Institute in the future.

I authorize Plan Institute to disclose this information to Vancouver Foundation for reporting purposes.

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* 11. If this form has been filled out by a third party on behalf of the applicant please write your name and phone number or email below:

Full Name:

Phone Number or Email:

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* 12. How did you hear about the Endowment 150 grant?

Through social media

Plan Institute/RDSP.com website

Plan Institute workshop/webinar

Plan Institute's newsletter

Plan Institute Helpline advisor

Financial advisor

From another organization/professional

Search engine / Online lookup

From Ministry of Social Development and Poverty Reduction (MSDPR)

Word of mouth

Other (please specify)