Charity Nomination Form
2027 nomination deadlines are January 2, March 9, July 14, and September 28.
Nominating Member Information
Member Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
I'm a member of:
*
Scottsdale
Ahwatukee
East Valley
What is your connection to this charity?
*
Volunteer
Board Member
Founder/Executive Director/Other Staff
Supporter
Other
Charitable Organization's Info
Name of Charity
*
Charity EIN Number
*
Year Charity Founded
*
Year organization became a 501(c)3 entity in Arizona. The organization must be a 501(c)3 for a minimum of three complete years to be eligible.
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Website
*
EX: http://www.nameofcharity.org
Name of Charity Contact
*
First Name
Last Name
Position at Charity
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Mission and Purpose
*
0/80
Primary Programs
*
0/135
Who does the charity serve and how many are served annually?
*
0/80
What geographic area is served by the charity?
*
Nominated charities need to serve Maricopa County populations.
0/50
How does the charity impact the Phoenix Metro area?
*
0/180
Organizations' Biggest Current Need:
*
0/55
How would our donation be used locally by the organization?
*
0/55
Number of Employees
*
Number of Volunteers
*
Has the charity ever operated under a different name?
*
Yes
No
Unsure at this time
If so, what was the previous name(s)?
Does the organization have 3 complete years of 990 tax returns available for review?
*
Yes
No
Unsure at this time
990 Financial Information
Rows
Most Recent Tax Year
Prior Tax Year
Prior Tax Year
Total Revenue
Total Expenses
Net Assets
Salaries, Independent Contractors, etc
Expenses Less Salaries
Program Expenses
Administrative Expenses
Fundraising Expenses
Will any portion of the 100+ WWC donation go towards administrative costs? If so, what percentage and how will this support the organization's infrastructure?
*
Is this charity a Qualifying Charitable Organization (QCO) or a Qualifying Foster Care Charitable Organization (QFCO)? Visit https://azdor.gov/tax-credits/credits-contributions-qcos-and-qfcos to look up the organization and code.
*
QCO
QFCO
Unsure
QCO or QFCO Code:
If the charity was selected to receive our quarterly donation, would someone from the organization be available to speak at the following quarterly giving circle to describe the impact of the donated funds to the group?
*
Yes
No
Unsure at this time
Does the organization agree to provide charitable tax receipts to our members?
*
Yes
No
Unsure at this time
Does the organization agree NOT to sell, give or use Member contact information for solicitations by themselves or other organizations?
*
Yes
No
Unsure at this time
Does the organization have a Donate button on their website?
*
Yes
No
If this charity is selected by the group, to whom would the checks be payable to?
*
Please verify that you are human
*
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