Non Profit Application

Is this a renomination?

Organization Name

Mission Statement

Nonprofit contact

First Name

Last Name

Nonprofit email

Nonprofit phone number

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Address to Mail Checks (Note: form requires country)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

EIN number

Year nonprofit organization founded

Year organization became a 501(c)(3) organization

Are you a granting organization (i.e. donate to other nonprofits vs individuals)?

If yes, please provide an explanation.

Number of employees

Number of volunteers

List of Board of Directors (BOD), name, email, and phone number.

What is the Board of Directors function?

What governance role does the BOD play in your programs and program outcomes?

Are your financial statements independently audited?

What is the main source of your funding and what percent of your funding does that source provide?

What is the geographic scope of your services throughout Door County?

Please provide an explanation of how you serve Door County including primary programs your organization offers to the community.

How would you define the impact your organization is making in Door County?

What is your annual program budget?

If you were to receive a donation from 100+ WWC, how would that donation be used?

If you were to receive a donation from 100+ WWC, who would the checks be payable to and where should checks be mailed?

If your organization is the recipient of our donation, do you agree not to sell, give or use our member’s contact information for solicitations by yourself or other organizations?

If your organization is selected to be presented to our members, would you or a representative from your organization be available to be present at our next quarterly meeting for Q&A after your organization is presented to the group?

If you previously received an award from 100+WWC and this is a resubmission, have there been any substantial changes to your organization since you received your award?

Questions/Comments