Welcome to the Canadian Insurance Scholarship Program online donation form. Please complete the following information to support high school graduates in Canada and their career in insurance. When you are finished, please click Submit Order to process your donation.

Your generous donation pays for the online video licensing preparation course and provincial exam fee.

If you have any questions regarding the Canadian Insurance Scholarship Program, please contact ILScorp at 1-800-404-2211 or email Shelley Ridgewell at Shelley@ilscorp.com

If you would prefer to be invoiced, please contact Shelley Ridgewell at shelley@ilscorp.com

* Denotes a required field.

SPONSOR INFORMATION
Company Name
Company Address
City
Postal Code
Phone Number
Contact Name
Company Website Address
I give ILScorp authorization to use our company name and company logo for promotional use as a Sponsor on the Canadian Insurance Scholarship and ILScorp.com websites.	Yes No
Any special Instructions for Scholarship (i.e. specific school, city, province)
This donation is on behalf of an individual
We would like to support The World of Opportunities Scholarship Program:
Enter # of $450.00 Donations*:
Total Sponsorship:
Name*:
Address*:
City*:
State/Province*:
Postal Code*:
Country:
Phone:
Email*:
Credit Card Number*:
Expiry Month (XX)*:
Expiry Year (XX)*:
CVN Number* (last three digits on back of card):