Mental Health Consumer/Survivor Employment Association of Essex County Charitable Number: 137962700 RR 0001 Campaign: Mental Health Awareness Ribbon - Donation Campaign Business Name: Business Address: Business Phone: Business Email: It is understood by the organization (MHCSEAEC) that there are risks involved in placing a donation canister at a business location that is open to the public. It shall be known to the Business that they will not be held liable for theft or damages of the donations and the collection baskets. By signing this document this is giving the organization (MHCSEAEC) permission to place the donation canister in your establishment. Collection of the canisters is byweekly and placement is for a ONE (1) month term. Collections are on the 15th and 30th of each month. Your help with this campaign is appreciated. Month to be Placed in Location: Contact Name: NOVEMBER DECEMBER JANUARY Signature: Campaign Organized and Maintained by: Ten Friends Diner - 1400 Windsor Ave, Windsor, ON N8X 3L9 - 519-254-3000 info@tenfriendsdiner.com Email: ABOUT THE CAMPAIGN: The goal of the campaign is to Raise Awareness surrounding Mental Illness. Education is key to spreading the news/word about Mental Health. The campaign now in the 2nd year is platformed to reach more than tripple the amount of people from last year. Through Business support this campaign helps with funding projects such as Ten Friends Diner's Mental Health Program as well as other projects such as a Community Garden, Food Planning Program, Counselling and Financial Planning Support for those who live with Mental Illness. Your Business/Organization's help by simply placing a donation canister on a front counter or desk helps in spreading the word and funding worthy projects that help those who live day to day with Mental Illness. Your Support is Greatly appreciated and we hope you can become a part of our YEARLY Campaign. We thank you in Advance! Mental Health Awareness Community Garden Initiative #LimeGreen Mental Health Awareness