2020 Up2Us Sports Summer VISTA Program

Organization + Contact Information

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* 1. Organization Location and Contact Information

Organization Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Website

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* 2. Name of Person Filling Out Form

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.

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* 4. Briefly describe your organization's history and mission.

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* 5. Organization's annual operating budget:

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* 6. Number of staff:

Full-time

Part-time

Annual volunteers

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* 7. What is the age range of youth served at the organization?

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* 8. Total number of youth served by your program across all activities?

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* 9. Percentage of youth participants who qualify for free or reduced-price lunch programs?

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* 10. Please list all of the sports or physical activities that your program provides. (Eg. basketball, dance, recess, yoga, etc.)

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* 11. Briefly describe how your organization uses sports specifically to address the needs of youth living in poverty:

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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.