COMPOSE AND SAVE YOUR ANSWERS IN A WORD DOCUMENT, THEN PASTE THEM INTO THE ONLINE APPLICATION IN ONE SITTING. THIS WILL PROTECT YOU IN CASE YOU HAVE TROUBLE SUBMITTING. PLEASE CALL US AT 202-549-6369 WITH ANY PROBLEMS. EVEN ON SAT 2/27 OR SUN 2/28.
| 1. Organization Name | |
| Address | |
| City |
State/Region
.
Zip |
| Qualified Locations |
. |
| Ward (Washington, D.C. only) |
. |
| Website URL (if you have one) | |
2. Executive Director: | |
| Director Name | |
| Director Title | |
| Director Email | |
| Director Phone | |
| Director Phone Type |
. |
3. Contact Person for Catalogue if you are selected:
| |
| Contact Name | |
| Contact Title | |
| Contact Email | |
| Contact Phone | |
| Contact Phone Type |
. |
| | |
| 4. Field of Philanthropy |
. |
Field Comments (optional) | |
| | |
5. Short description of your organization (10 word limit) | |
6. Statement | (Note: Please refer to application instructions for FULL description of what is asked for in each section. The headings here are brief reminders.) |
| 6.1. your organization's identity and mission: who are you? | |
| 6.2. a brief history; how and why your organization came into being | |
| 6.3. staffing: note executive staff, development staff, program staff; include full and part time equivalent | |
| 6.4. your board: who they are/the nature of their engagement with your organization/whether and to what degree they are financial contributors; board policy on financial support | |
| 6.5. your purpose/the need you address; three organizations closest to you; how you are different from them | |
| 6.6. what you do: programs, services, activities; target population(s), number of people served; please provide a detailed description | |
| 6.7. what impact do you have? what do you measure, how do you measure, and how do you define success? | |
| 6.8. short- and long-term goals of your organization; strategies for achieving these goals and progress made toward them | |
| 6.9. challenges/struggles/failures of the last year; accomplishments of the last year(s) | |
| 6.10. evidence of excellence: awards, citations, honors, etc. | |
| 6.11. costs for administration, fundraising, and program; percent of the total for administration/fundraising; note any special circumstances; listed on any watchdog sites? | |
| 6.12. total amount you raise, and the percent of funds you receive from different sources: government, individuals, foundations, corporations, United Way, CFC, special events, etc.; capacity to raise money from, and to steward, individual donors | |
| 6.13. any special project or activity for which you may be seeking funds (not required)? | |
| 6.14. explanation of what is special about your story that illuminates for donors the values of philanthropy at its best | |
| |
Please list four WISH LIST items that correspond to the amounts named,
in the order given. Remember, wish list items should be both concrete
and specific ($500: tuition for 2 students to attend 4 weeks of summer
training camp). See application instructions for more examples.
|
7. Wish List
| |
| | |
8. Key Programs, Services, and Activities (150 word limit) | |
| | |
| 9. Some Additional Information | |
| | |
| Proposal Type |
. |
| If you been selected and featured before... in which year? (Re-listings only) | |
Have you applied in previous years? (y/n) If so, in which year(s)? | |
| Is your 501(c)3 status current? (y/n) | |
Do you have an "Advance Ruling" from the IRS? (y/n) If yes, when does it expire? | |
| Is your budget $3 million or under? (y/n) | |
| Your budget: |
. |
Do you typically solicit funds from individual donors? (y/n) | |
Do you typically receive donations from unsolicited/unknown donors? |
. |
| EIN | |
| Guidestar Name (if significantly different) | |
If your Guidestar Name is different from your organization's name above, why? (optional) |
. |
| | |
| 10. Who wrote this application? | |
| Name | |
| Title |
. |
| Email | |
| Phone | |
| Phone Type |
. |
| Comments? (optional) | |
| 11. How did you hear about the Catalogue? |
. |
| Any details? -or- Other method? (optional) | |