CHARITABLE ORGANIZATION FACT SHEET
1. Name of Charitable Organization:_____________________________
2. Address: (Headquarters and where services are provided, if different)
________________________________________________
3. Web address of organization:
_______________________________________________________________
4. When was the organization started? ____________________
5. Mission Statement of the Organization:
______________________________________________________________
______________________________________________________________
______________________________________________________________
6. How would the donated funds be used?
______________________________________________________________
______________________________________________________________
7. What are the current sources of funding for the Organization?
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
8. What population does the Organization serve? (children, women, elderly, mentally ill, etc.) AND how may people will receive services annually (approximately) if known?
______________________________________________________________
______________________________________________________________
______________________________________________________________
9. Is the Organization a registered 501(c)(3) (IRS Certified Tax Free Status) charitable Organization?
Yes_______ No_______ EIN# ____________________________
Please Note: while a non 501(c)(3) organization is still eligible for consideration, contributions will not be tax deductible so therefore Members must be aware of this status prior to voting.
10. If awarded, would someone from the Organization be available to speak at our next meeting to describe the impact of the donated funds?___ If Yes, Name & Contact Information:
_____________________________________________________________
11. Does the Organization agree not to sell, give, or use the 100+ Women’s contact information forsolicitations by themselves or other organizations?
_____________________________________________________________
12. If this charity is selected by the group, to whom would the check be payable to?
______________________________________________________________
13. Does any portion of a contribution go toward administrative fees? _____________________________
1. Name of Charitable Organization:_____________________________
2. Address: (Headquarters and where services are provided, if different)
________________________________________________
3. Web address of organization:
_______________________________________________________________
4. When was the organization started? ____________________
5. Mission Statement of the Organization:
______________________________________________________________
______________________________________________________________
______________________________________________________________
6. How would the donated funds be used?
______________________________________________________________
______________________________________________________________
7. What are the current sources of funding for the Organization?
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
8. What population does the Organization serve? (children, women, elderly, mentally ill, etc.) AND how may people will receive services annually (approximately) if known?
______________________________________________________________
______________________________________________________________
______________________________________________________________
9. Is the Organization a registered 501(c)(3) (IRS Certified Tax Free Status) charitable Organization?
Yes_______ No_______ EIN# ____________________________
Please Note: while a non 501(c)(3) organization is still eligible for consideration, contributions will not be tax deductible so therefore Members must be aware of this status prior to voting.
10. If awarded, would someone from the Organization be available to speak at our next meeting to describe the impact of the donated funds?___ If Yes, Name & Contact Information:
_____________________________________________________________
11. Does the Organization agree not to sell, give, or use the 100+ Women’s contact information forsolicitations by themselves or other organizations?
_____________________________________________________________
12. If this charity is selected by the group, to whom would the check be payable to?
______________________________________________________________
13. Does any portion of a contribution go toward administrative fees? _____________________________
