2023 ISC Awards Application – Community Spirit Step 1 of 2 50% Your contact informationName First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail What is your representative number? Please select the DSA Canada member company you are associated with:ACN CanadaAmway CanadaArbonne CanadaAvon CanadaChalk CoutureCutco/Vector Marketing CanadaEnerUp WorldImmunotecInfinitusJuice Plus+ CanadaMannatechMary Kay CosmeticsMONAT Global CanadaNoevir CanadaNu Skin CanadaOrgano GoldPampered Chef CanadaPlexus CanadaPM-InternationalRodan + FieldsSaladmasterScentsy CanadaSeneGence InternationalShaklee CanadaShe's Got LeggzSipology by Steeped TeaSoulLifeStampin' Up CanadaSunrider International - CanadaThirty-One Gifts CanadaTocaraUSANA Health SciencesYouniqueOther Tell us about yourselfPlease provide us with a brief bio. This bio will be used to describe you if you proceed to the final round.Please name the Canadian charity or program that you are active in. Please provide a brief description of the charity or program's main objective. When did you start volunteering/participating in this charity/program? YYYY-MM Approximately how many hours do you volunteer for this charity/program per month? 0 - 8 hours 9 - 39 hours Over 40 hours How much money have you helped raise for this charity/program? Is the charity/program still active today? Yes No Approximately how many people does this charity/program help? 0 - 500 501 - 1,000 1,001 - 5,000 Over 10,000 Please provide an example of how your participation in this charity/program has helped your community.How has direct selling impacted your life?What would winning the award mean to you?Anything else you'd like to share?Upload your business headshot.Accepted file types: jpg, png, Max. file size: 9 MB.Please upload any supporting documents. Drop files here or Select files Max. file size: 32 MB. For example, publicity, dollars raised, communication, feedback, testimonials, etc.Consent to use my information. I wish to opt-in to receive email communications from DSA Canada. By checking this box, I am confirming that I agree to receive communications by email or otherwise, as it pertains to the Awards Selection Process and my entry. Consent to enter the DSA Canada ISC Awards Selection Process.(Required) By checking this box, I am confirming that I have read and understood the Awards Selection Process. I hereby agree to adhere to all guidelines as a potential entrant for this award.By submitting my application, I agree to have my name, photo, bio and any other information DSA Canada deems necessary in the promotion of the ISC Award winners to be published in all DSA Canada communication outlets including, but not limited to, newsletters, social media DSA Annual Conference materials and the DSA Canada website, without further remuneration. I certify that I meet the eligibility requirements of the award I am applying for and the information provided is complete and accurate.