Blacksburg Battles Cancer Donation Application

Blacksburg Battles Cancer Grant Application

The Blacksburg Country Club's Women's Golf Association (BCCWGA) is dedicated to raising funds for cancer-focused non-profit organizations that serve the local (Blacksburg and the NRV) community. These organizations shall engage in research to prevent, treat or cure cancer and/or provide supportive services to cancer patients and their families.

Since its inception in 2013, Blacksburg Battles Cancer has donated over $160,000 to non-profits that serve our region, including Special Love/Camp Fantastic, American Cancer Society (Blue Ridge), Carilion Clinic Hospice, Good Samaritan Hospice, Komen Virginia Blue Ridge, Christina Phipps Foundation, and Students vs. Cancer.

Please complete the form below for consideration to be a recipient organization. Decisions about grants are made throughout the year. Non-profits may apply multiple times for specific projects, programs, or events; however, organizations will not be awarded more than one grant per year.

Grants will be awarded for specific programs, projects, or events and generally not for ongoing operating expenses.

To read more about Blacksburg Battles Cancer, visit www.blacksburgbattlescancer.org

Question Title

* 1. Please provide the following contact information.

Submitter or Main Contact

Organization

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 2. Please tell us how the activities of your organization fit in with the BCCWGA Mission.

Question Title

* 3. Please check the appropriate boxes to indicate a "Yes" answer to the following statements for the three most recent tax years. (Leave blank for a "no" answer.)

	Most recent year	Year prior to most recent	2 years prior to most recent
990s available for review (please email a copy of your most recent 990 to info@blacksburgbattlescancer.org)	990s available for review (please email a copy of your most recent 990 to info@blacksburgbattlescancer.org) Most recent year	990s available for review (please email a copy of your most recent 990 to info@blacksburgbattlescancer.org) Year prior to most recent	990s available for review (please email a copy of your most recent 990 to info@blacksburgbattlescancer.org) 2 years prior to most recent
Did not operate with a deficit	Did not operate with a deficit Most recent year	Did not operate with a deficit Year prior to most recent	Did not operate with a deficit 2 years prior to most recent
Over 70% of revenue is used directly towards the mission of your organization	Over 70% of revenue is used directly towards the mission of your organization Most recent year	Over 70% of revenue is used directly towards the mission of your organization Year prior to most recent	Over 70% of revenue is used directly towards the mission of your organization 2 years prior to most recent
In "Good" standing with the IRS	In "Good" standing with the IRS Most recent year	In "Good" standing with the IRS Year prior to most recent	In "Good" standing with the IRS 2 years prior to most recent

Question Title

* 4. For the above question, indicate which tax year is your most recent.

Question Title

* 5. Please tell us about the mission of your organization or enter your mission statement.

Question Title

* 6. What mechanisms are in place regarding the use and dispersal of funds within your organization and/or to your recipients. Describe the vetting process if funds are given to individuals, families, or other entities.

Question Title

* 7. BCCWGA donations typically range from $1,000 to $10,000. Please describe the specific new or expanded program, project, or event for which you are requesting a grant and the size of grant you are seeking. (If you would like to submit for multiple projects, you can break them down by paragraph and assign a dollar amount to each project.)

Blacksburg Battles Cancer Donation Application

Blacksburg Battles Cancer Grant Application

Question Title

* 1. Please provide the following contact information.

Question Title

* 2. Please tell us how the activities of your organization fit in with the BCCWGA Mission.

Question Title

* 3. Please check the appropriate boxes to indicate a "Yes" answer to the following statements for the three most recent tax years. (Leave blank for a "no" answer.)

Question Title

* 4. For the above question, indicate which tax year is your most recent.

Question Title

* 5. Please tell us about the mission of your organization or enter your mission statement.

Question Title

* 6. What mechanisms are in place regarding the use and dispersal of funds within your organization and/or to your recipients. Describe the vetting process if funds are given to individuals, families, or other entities.

Question Title

Question Title

* 8. Is there anything else you would like to share about your organization and why it would be a good fit with BCCWGA.

Question Title

* 9. Please enter the URL for your organization's website.

Question Title

* 10. If you are a previous grant recipient, please tell us specifically how previous funds were used from your Blacksburg Battles Cancer grant.