Nonprofit Collaboration Form

This form is intended to help United Way learn more about your organization. It is not a funding application. This form is to be used by non-profit organizations who want to pursue potential opportunities to partner with United Way. Submitted forms are reviewed periodically. You can expect to hear from a United Way staff person with suggestions for next steps.

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* 1. Date:

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* 2. Agency Information

Agency Name

Executive Director Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. What is your mission statement?

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* 4. Who do you serve? Please describe specific target communities, regions and/or populations.

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* 5. What are your organization's outcomes (or indicators of success)?

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* 6. In terms of collaborating with United Way, what is your organization most interested in?

Providing opportunities for volunteers to serve at my nonprofit (ex: Year of Caring)

Learning more about United Way volunteer opportunities/events where our employees can participate, such as United Way Readers, Year of Caring, etc.

Participating in United Way initiatives (as available) that add value or capacity to our programs

Professional training and development for staff who are providing front-line services

Opportunities to collaborate with organizations already part of the United Way network

We are interested in calls to action for advocacy around public policy

Other (please specify)

Nonprofit Collaboration Form

Question Title

* 1. Date:

Question Title

* 2. Agency Information

Question Title

* 3. What is your mission statement?

Question Title

* 4. Who do you serve? Please describe specific target communities, regions and/or populations.

Question Title

* 5. What are your organization's outcomes (or indicators of success)?

Question Title

* 6. In terms of collaborating with United Way, what is your organization most interested in?

Question Title

* 7. Has your organization worked with United Way in the past? If you have received grant support, please share that here.

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* 8. Is there a specific United Way project or initiative that you want to learn more about?