Fiscal Sponsorship Application

Sponsorship Type *

What is the name of your program/project/organization for which you are seeking fiscal sponsorship? *

E-mail *

Organization/Project Website *

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Do you currently have funding for your program/project/org? *

Do you currently have or expect to apply for any type of government funding (city, county, state, federal)? *

Where do you expect the funding to come from? (please check all that apply) *

Individual donations
Foundation grants
Corporate grants
Fees for service
Other

What model of Fiscal Sponsorship are you seeking? *

Model A
Model C
I don't know
Other

Is your program/project/organization currently being fiscally sponsored by another organization? *

Is your program/project/organization incorporated as any type of legal entity? *

What is your anticipated revenue budget for the next 12 months? Please note, we would like to see only realistic, achievable fundraising goals. *

Have you submitted the 1023 (or 1023EZ) form to the IRS for tax exemption and are awaiting your letter of determination? * *

What is the charitable mission and purpose of your program/project/organization?

Please tell us what problem/challenge your project seeks to solve. *

Please also tell us what the expected positive influences of your project will be including how many people will benefit as a result of your work or any other benefit to community/society/planet. *

How does your project seek to solve the challenge/problem?

Please provide a list of current and/or proposed activities that your project will engage in. Please be specific, realistic and as thorough as possible *

Will your project have employees? *

Yes, plan to have employees
Yes, currently have employees
No

Do you currently have or plan to work with volunteers? *

Yes, plan to work with volunteers
Yes, currently work with volunteers
No

Will your project work directly with any of the following population? *

Youth - under 18
Senior Citizens - over age 65
Persons with disabilities
Animals
(Organization) not be working with any of these populations

Do you currently have or intend to develop any significant intellectual property? *

Yes
No
Not sure

For example: recorded videos, audio; curricula and workshop materials; web applications, etc...

Will your project host or organize events with more than 50 people in attendance?

Do you plan on trying to sell things to raise money e.g. T-shirts, stickers, etc…? (copy)

Is there anything else you would like to tell us about your program/project/organization that you feel we should know or understand?

How did you hear about us?

Fiscal Sponsorship

What is the charitable mission and purpose of your program/project/organization?

How does your project seek to solve the challenge/problem?

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