501(c)(3) Organization Qualifications

Please tell us about your organization.

Contact Person *

First

Last

Organization Name *

Website / URL

Email *

Phone *

ORGANIZATION BOARD

1. Please list the total number of board members for your organization.

2. Please list "EACH" Board Member. Include: Name, Title, Email, Phone, Affiliation. Example: John Doe, Board President, John@abcfoundation.org, 555-555-5500, Affiliated with: Delta Airlines and the Boys and Girls Club.

3. Will any Board member be involved with the daily management of the organization? If so, please explain?

4. Will any board members be paid for their services? If so, please explain?

5. Will the organization enter into a business agreement for services, products or leased space with a board member? If so, please explain.

ORGANIZATION KEY STAFF

6. Staff Person #1 Title and Annual Salary: (EXAMPLE: Executive Director, $54,000 base pay).

7. Staff Person #1 Job Description (Please describe what this person will do each day. And, send the Job Description for this position to support@dewlyn.com)

8. Staff Person #2 Title and Annual Salary: (EXAMPLE: Program Director, $48,000 base pay).

9. Staff Person #2 Job Description (Please describe what this person will do each day. And, send the Job Description for this position to support@dewlyn.com)

10. Staff Person #3 Title and Annual Salary: (EXAMPLE: Case manager, $38,000 base pay).

11. Staff Person #3 Job Description (Please describe what this person will do each day. And, send the Job Description for this position to support@dewlyn.com)

12. Staff Person #4 Title and Annual Salary: (EXAMPLE: Volunteer Coordinator, $35,000 base pay).

13. Staff Person #4 Job Description (Please describe what this person will do each day. And, send the Job Description for this position to support@dewlyn.com)

14. Staff Person #5: Title and Annual Salary

15. Staff Person #5 Job Description (Please describe what this person will do each day. And, send the Job Description for this position to support@dewlyn.com)

16. Please estimate how many volunteers will you have?

17. Please estimate the total number of hours that each volunteer will serve each month:

18. Please describe volunteer duties:

ORGANIZATION PARTNERS

19. Please list each organization that you will partner with, where they are located, and how you plan to partner with them. (EXAMPLE: The Goodwill, Atlanta, GA, USA. We will partner with them for participant clothing).

Partner #1

Partner #2

Partner #3

Partner #4

Partner #5

Additional Information

Please use the space below to share additional information or to ask a pressing question about the application process.

Name