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$Million Dollar Challenge
Organizational Application
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Indicates required field
Name
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First
Last
Email
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1) What is your title and/or role with the organization?
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2) Legal name of the organization
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3) Check every box that applies to your organization:
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Tax-exempt 501(c)(3)
Tax-exempt* (Other - use box below)
Public school
Faith-based organization
Government entity
Profit business
Sole proprietorship or partnership
Limited Liability Corporation (LLC)
Corporation* (Other - use box below)
*Other: Specify type of tax-exempt organization and/or type of corporation
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4) Where is your organization located? (City and State)
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5) What is your organization's website address?
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6) Has your organization previously received grant funds?
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Yes
No
If "Yes" use the box below to enter the following four items of info for each grant received:
Name of funding source
Amount of grant
Purpose of grant
Year(s) grant awarded
Comment
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7) How long has your organization been in existence?
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1 - 3 years
4 - 5 years
6+ years
8) How many board members does your organization have?
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9) Has your board established an annual contribution requirement for individual board members? Choose One
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Yes
No
9a) If "yes" to the question above, indicate the type of requirement. Choose One:
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Give (from personal resources)
Get (from outside resources)
Give or Get (can be either or a combination of the two resources)
9b) If "Yes", what is the required amount per year?
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10) Indicate the month and day of the organization's fiscal year.
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11) How much is your organization's current annual budget?
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12) List and briefly describe the organization's main source(s) of funding.
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13) What is the last fiscal year an IRS Form 990 was filed?
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14) Place a check mark next to each financial statement that your organization has readily available.
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Balance Sheet for most recent month or quarter of this year
Balance Sheet for most recent fiscal year
Operating Statement/Income Statement for most recent month or quarter
Operating Statement/Income Statement for most recent fiscal year
15) How many employees on payroll (W-2)?
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16) Does your organization have any current contractors/consultants?
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Yes
No
17) What is the organization's Mission Statement?
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18) List and provide a brief description of the organization's main programs
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19) Total number of clients served annually?
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20) Total number of clients served so far this year?
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21) Key Partners and Collaborators:
Prepare a list of key partners, along with a brief description of their roles in collaboration with you. The list may include other nonprofits, publicly-funded entities like schools, museums, Parks & Recreation, churches and other faith-based organizations, businesses and elected/appointed public officials.
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22. Use the box below to enter any additional information you would like to share about your organization.
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You will receive an email with feedback on your application within 48 hours* (*or within 2 business days).
Submit
HOME
The Author
$MDC Requirements
Grantbuilder Workbook
CONTACT US