Funding Application

Funding Application

Thank you for your interest in applying for funding from Marshfield Area United Way.

Please follow the instructions carefully. Our volunteers need clear, concise and complete information to enable them to review your request. United Way staff is available to answer technical questions about the application.

2019 Instructions & FAQs

Applications Accepted until Friday, November 16, 2018, at 4:00 pm.

For more information call: 715-384-9992 or email: unitedway.paula@solarus.net

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Today's Date

Agency/Program Name

Executive Director

Contact Person (if other than Director)

Mailing Address

City

State

Zip Code

Phone

Fax

Website

Agency Mission Statement

Total Agency Operating Budget Last Fiscal Year

Total Agency Operating Budget Current Fiscal Year

Dollar Amount of United Way Funding Request

Funding Request for 2019 to Marshfield Area United Way

Name of Program/Project for which you are seeking funding

Brief Summary of Program and its Intended Outcomes

Focus Area

Need

Program Outcomes/Impact

Indicators

Supporting Documents

Sources of Funding

Program Budget Balance

What is your agency's fiscal year?

Agency Overhead Rate

Does your agency have an operating reserve?

What was balance at end of most recently completed fiscal year?

How many months does the reserve cover?

Does your agency have an endowment fund?

What was the balance of the endowment at the end of the most recently completed fiscal year?

Do you reinvest the interest earned or use the interest? (explain)

Program Overview

Program Budget Sheet

Utilization of Funds

IRS Form 990, Form 990 EZ, Form 990 PC

Roster of Board Members and Officers and community they reside in.

Financial statement for most recently completed fiscal year

Most Recent Annual Report, if available.

Articles of Incorporation

By-laws

Proof of Tax-Exempt Status under Section 501(c)3 (or other relevant section) of IRS Code*

Signature

Thank you for your interest in applying for funding from Marshfield Area United Way.

Applications Accepted until Friday, November 16, 2018, at 4:00 pm.

For more information call: 715-384-9992 or email: unitedway.paula@solarus.net

It is required to log in to use this form. If you do not already have an account, please register here

It is required to log in to use this form.
If you do not already have an account, please register here