Nonprofit Proposal Questionnaire Please enable JavaScript in your browser to complete this form.Dewlyn Nonprofit Services uses this questionnaire to gather a large amount of information in a concise and efficient way. We have added both open and closed questions to collect data that will help us understand your organization, project, and funding goals. Note: This form does not represent a business relationship or an agreement to engage in formal services. Once this form has been completed and submitted, we will contact you to discuss our next steps if it is determined that we are able to assist you.SECTION 1: About Your OrganizationPrimary Contact Name *FirstLastContact Title *Organization Name *Organization AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCounty *Email *Website / URLPhone *Date Organization Originally FoundedDate Organization became 501(c)(3) Tax-Exempt Employee Identification Number (EIN) How is organization structured? * For-ProfitNon-Profit CorporationNon-Profit (Other)We do not have a legal structure yetSECTION 2: About Your Board of DirectorsThe number of Directors and Officers required vary from state to state. A best practice is to have at least 3 (unrelated) individuals to serve your organization. Typical Board positions are: Board Chair, Board Treasurer, Board Secretary, and Board Member. Number of Directors: *THE BOARD CHAIRFirstLastChair's EmailChair's Phone Number:Chair's AffiliationsExample: Serves on the Board of ABC Foundation, works for Delta Airlines, Regular volunteer with Boys and Girls Club of America.THE BOARD TREASURERFirstLastTreasurer Email"Treasurer Phone Number:Treasurer's AffiliationsBOARD SECRETARY *FirstLastSecretary Email *Secretary Phone Number:Secretary's AffiliationsPlease use the space provided to list all other board members. List their name, email, and affiliationsSECTION 3: About Your Organization's ActivitiesIn under 20 words, please state your organization's mission: *Please list each service that your organization provides *Describe your target populationWhich city, county, and state does your target population live in?Is there a fee for your services? *Address where services are renderedAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhat are your hours of operation?Which other organizations are providing similar services to yours?SECTION 4: About Your PartnersHow many regular volunteers do you have?What do your volunteers do for the organization? (Or, what will they do?)How many partners to you have (formal and informal)?Please list each partners name and briefly describe what they do for the organization.SECTION 5: About Your Income and ExpensesWhat is your annual budget amount? (i.e. how much have you planned to spend on the program during this current fiscal year)?How much INCOME was generated during your last fiscal year?How much INCOME has been generated YTD (during this current fiscal year)?What were your total EXPENSES during your last fiscal year?How much have your spent on the organization YTD (during this current fiscal year)?Please list each person or organization that has contribution to your organization in any way this year. Also list the amount of the contribution or describe the donation. Please list what you have spent money on this year (for your program). List the item/service and the amount spent.SECTION 6: About Your Funding RequestHow much are you seeking in funding?Note: Our proposals are for entry level funding. We no longer write proposals for amounts that exceed $100,000.What are you seeking funding for? * Organizational OperationsA specific program or projectI would like to discuss thisIf awarded, what will you spend the money on?Are you seeking in-kind donations or something other than money? If so, please explain:SECTION 7: About the FounderWhy was the organization founded? Please be as detailed as possible.Thank you!You attest that this information is true to the best of your knowledge. * Yes, this information is correct.Submit
