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Host Site Information
*
1.
I have read and understand the Community Sponsor Information including the obligations of a sponsor organization.
(Required.)
Yes
No
2.
Contact Information
Name of Project Contact
Organization
Street Address
PO Box/Other
City/Town
State
ZIP Code
Email Address
Phone Number
*
3.
Organization Employer Identification Number (EIN):
(Required.)
4.
Organization website URL:
*
5.
Select the applicant's type of organization.
(Required.)
Nonprofit
State, county or local government
Educational institution
Faith-based organization
Tribal government
Regional organization
Other (please specify)
*
6.
Does your organization have regular audits performed?
(Required.)
Yes
No
7.
.
If "YES", how often and who does it?
If "NO", who reviews agency financial reports and how often?
Documents required with application. Upload these on the final page of this online form.
A staff organizational chart
List of governing board members, county commissioners, town council members (whatever is applicable)
Proof of organizational eligibility (IRS letter with tax exempt status OR W9)
Attachment A: Project Work Plan
