Starting a Nonprofit -Questionnaire Please enable JavaScript in your browser to complete this form.Hello! Thank you for your interest in our services! We'd love to help you form your organization, but first we'd like to learn more. After completing this form, you'll be directed to a link to schedule your phone meeting with Cheryl Smith. Thank you! ABOUT YOUR ORGANIZATIONContact Person: *FirstLastOrganization Name: *Organization Address: *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWebsite / URL:Organization Email: *Organization Phone: *Employer Identification NumberDo you think you'll generate more than $50,000 in any of the next 3 years? YesNoI am not sureDoes this organization have assets that exceed $250,000 fair market value? YesNoI am not sureAre you applying for reinstatement of a previously revoked 501(c)(3) organization? YesNoI am not sureWhat is the date of revocation?ORGANIZATION STRUCTUREHow is your organization structured? Nonprofit CorporationNonprofit LLCFor Profit Corporation or LLCUnincorporated AssociationTrustI do not have a legal structure yetPlease list the date of incorporation (only if applicable):Please list the State that you are (or intend to be) incorporated in:REGISTERED AGENTRegistered Agent Name. *FirstLastRegistered Agent's Address (must be a physical address location; no P.O. Box). *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhich County is your Registered Agent located in? *Registered Agent Phone Number: *Registered Agent's Email Address: *How many board members do you have? (need at least 3) *Note: You must have a minimum of 3 Board members. These individuals "cannot be the same person" and the majority of your Board members must be "unrelated" to each other.Do you intend to compensate Board members? * YesNoI am not sureORGANIZATION ACTIVITIESTo qualify for exemption as a section 501(c)(3) organization, you must be organized and operated exclusively to further one or more of the following purposes. Which of the following "purposes" apply to your organization?CharitableScientificTo foster national or international amateur sports competitionReligiousLiteraryEducationalTesting for public safetyPrevention of cruelty to children or animalsOrganization's mission statement (under 20 words): *Organization's most significant activities:List the services that you will provide to the public. A service is something that you "do" - for example: feed the hungry, provide housing or shelter, tutor children, rescue animals, etc.Will your organization conduct activities outside of the United States? YesNoI am not sureIf your organization will conduct activities outside of the United States, please tell us which countries?Will your organization provide disaster relief? YesNoI am not sureWill your organization provide grants or assistance to individuals or other organizations? YesNoI am not sureFoundation ClassificationWill this organization be established as a Public Charity or Private Foundation? Public Charities generate a substantial amount of its income to further its mission from public sources (grants, donations, contributions from the public or government). Whereas, private foundations substantially obtain their income from private sources (such as an individual, family or company), and these organizations support the work of public charities. * Public CharityPrivate FoundationI am not sureAdditional InformationPlease use the space below to share additional information or to ask a pressing question about the application process.Thank you for completing this questionnaire. Your responses will guide our understanding of your organization and areas where we can offer you support. Once you click "submit" you will be guided to a page to schedule your phone meeting with Cheryl Smith. I certify that the information provided is true based on my understanding. Yes, the information I have provided is true.WebsiteSubmit