Freedom to care – Application form for a regulatory exemption

Guide and worksheet

To help make applying for an exemption easier, first prepare a draft of your application by filling out the Application for New Regulatory Exemption – Guide and Worksheet.

When you are satisfied with your draft application, transfer your responses into the online application form below.

Application form

Fill out this form online to apply for a one-time, short-term exemption from regulations – if an exemption does not already exist.

You cannot save your progress in this fillable form. We encourage you to use the guide and worksheet above – before you fill out the form.

All fields are required unless otherwise indicated.

General contact information for the organization

Legal name of organization

Common name of organization

Indicate the Act your organization is incorporated or registered under

If you selected 'other' above, please specify the Act (optional)

Incorporation/registration number

Incorporation/registration date

Organization address

Street address

City

Province

Postal code X0X 0X0

Website address https://www.domain.ca (optional)

Primary contact for this application

Name

Organization position title

Phone number 5555555555 x55555

Email address [email protected]

Legal authorized signing authority for the organization

Name

Organization position title

Phone number 5555555555 x55555

Email address [email protected]

Organization overview and context

Describe your organization's mandate/purpose, vision and mission

Describe whom (clients/members) your organization serves

What are the primary services provided by your organization?

Describe the public benefit your organization provides. (* Refer to the application guide.)

How accessible are your programs and services to the general public?

Fully accessible to anyone

Blended with some programs, services and resources available to everyone with others restricted to members only

Restricted to members only

Exemption Request

Has your organization previously applied for any exemptions under the Freedom to Care Act?

If yes, provide a brief description of the exemption requested. (optional)

What regulation are you requesting exemption from? Include the name of the Act, the Regulation, and the specific section(s)

Has your organization requested an exemption under this regulation before?

If yes, provide a brief description of the exemption requested. (optional)

Start date for requested exemption period

End date for requested exemption period

Describe the issue(s) or problems this regulation is causing. How is this regulation impeding your organization’s ability to do social good and provide public benefit?

Describe how an exemption to this regulation will make it easier for your organization to do social good and provide public benefit.

Describe any other potential benefits that may result from an exemption to this regulation. (* Refer to the application guide.)

Describe any possible impacts or risks that may result from an exemption to this regulation. (* Refer to the application guide.)

Describe how you would mitigate the potential impacts and/or risks identified above?

Provide a list all of the stakeholders that would be impacted by this exemption should it be granted.

I hereby acknowledge that:

The information contain in this application is true, accurate, and complete.

I am a representative with designated signing authority / decision-making authority in our Organization.

The Organization’s Board of Directors is aware of and supports this application.

The personal information collected through the ‘Freedom to care – Application form for a regulatory exemption’ web page will be used for the purpose of administering the Freedom to Care Program and providing you with program updates.

This personal information collection is authorized under section 33(c) of the Freedom of Information and Protection of Privacy (FOIP) Act.

If you have any questions about this collection of personal information, you may contact the Senior Manager, Community Development Unit, at [email protected].

Forms:

Application for a regulatory exemption

Submit a question

Documents:

Application for a New Regulatory Exemption – Guide and Worksheet

Exemption to Regulatory Requirements Fact Sheet

Insurance Toolkit for the Voluntary Sector

Scope of Duties Considerations for Non-profit Organizations

Volunteer Liability Protection Fact Sheet

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