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2020 Up2Us Sports Summer VISTA Program
Organization + Contact Information
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1.
Organization Location and Contact Information
(Required.)
Organization Name
Address
Address 2
City/Town
State/Province
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
Country
Website
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2.
Name of Person Filling Out Form
(Required.)
Name
Role/Position
Email Address
Phone Number
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3.
Organization EIN#
Also known as the Federal Employer Identification Number (FEIN) or the Federal Tax Identification Number, the EIN is a unique nine-digit number assigned by the Internal Revenue Service (IRS) to business entities operating in the United States for the purposes of identification.
(Required.)
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4.
Briefly describe your organization's history and mission.
(Required.)
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5.
Organization's annual operating budget:
(Required.)
*
6.
Number of staff:
(Required.)
Full-time
Part-time
Annual volunteers
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7.
What is the age range of youth served at the organization?
(Required.)
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8.
Total number of youth served by your program across all activities?
(Required.)
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9.
Percentage of youth participants who qualify for free or reduced-price lunch programs?
(Required.)
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10.
Please list all of the sports or physical activities that your program provides. (Eg. basketball, dance, recess, yoga, etc.)
(Required.)
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11.
Briefly describe how your organization uses sports specifically to address the needs of youth living in poverty:
(Required.)
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12.
The Summer Associate VISTA Program will be implemented over a short time line. Recruitment is critical for the success of the program. Recruitment will fall predominately on host sites. Please describe your recruitment strategy.
(Required.)
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