Impact Company Application

Impact Company Application

This application is intended for companies that have a donor/investor ready to recommend an investment of charitable capital.
Please note that Impact Foundation requires companies to have a donor/investor in order to complete this application.

Why is this a requirement, and how does Impact Foundation support companies looking to raise capital? We are a charity that sponsors donor advised funds. This means we enable donor/investors to recommend how the assets in their Impact Foundation fund will be invested and granted. We do not have a pool of capital ready to be deployed.
Is there currently someone ready to recommend an investment of charitable capital in your company? We call this person a donor/investor.*

NoYes
Please give the name of the donor/investor:*
If multiple donor/investors, please list each name separated by commas
How much has the donor/investor committed to invest?*
If multiple donor/investors, please list each commitment amount separated by commas
Does the Donor/Investor currently hold any ownership in the company, its parent, or subsidiaries?*

YesNo
Please do NOT include the proposed ownership through Impact Foundation, should we make this investment with charitable capital.

We are seeking to understand the Donor/Investor's other ownership in the company, which is an important compliance question for us in investing with their contributed capital.
If yes, please describe:

Thank you for getting in touch!
Please note that we can only process applications from companies which have a donor/investor ready to recommend an investment of charitable capital.

Why? Impact Foundation is a charity that sponsors donor advised funds. This means we enable donor/investors to recommend how the assets in their Impact Foundation fund will be invested and granted. We do not have a pool of capital ready to be deployed.

If you would like to learn more about Impact Foundation, please feel free to email Sharon at sharon@impactfoundation.org

Impact Company Application

We encourage you to gather all necessary documents before beginning this application.
Our vetting team needs to review certain information about each proposed investment.

The items you will need to complete this application are listed below, and must be provided for the exact legal entity we would be investing into.

Contact Information

Company Details
- Description of products/services
- Structure (ex: S-Corp, or LLC)
- Industry
Description of Social, Environmental, or Spiritual Impact
- Description of impact
- List of impact metrics you are tracking
Investment Details
- Amount of investment
- Type: debt or equity
- Basic investment terms
- Closing date
Documents to Upload
- Business Plan/Marketing Plan
- Biographies of Key Management
- Articles of Organization/Incorporation
- Term Sheet (if available)
- Capital Structure: pre- and post-capital raise
- Private Placement Memorandum (if available)
- Transaction Documents: Subscription agreement, stock purchase agreement, loan agreement, and other (as applicable)
- Bylaws or Operating Agreement
- Current and prior financials (3 years, if available)
- Financial projections if all funds are raised
- Wire instructions for your bank, including company's local address
- ACH instructions for your bank
- Image file for your company logo
Additional Documents for Secured Debt Only
- Property address or description
- Recent Title Insurance Report (if available)
- Property Appraisal (if available)

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Impact Company Application

To start, please provide your direct contact information. This is how we will reach out with any questions regarding your application.
Your Name*

First NameLast Name
Your Email*
example@example.com
Direct Phone Number*

Country CodeArea CodePhone Number

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Impact Company Application

Next, help us to understand your company's structure and operations.
Company's Legal Name*
If you operate under another name (e.g. a DBA) please provide that as well. For example: "Legal Name (DBA Name)"
Is the company named above the exact legal entity that Impact Foundation would be investing into?*

YesNo

What is the name of the legal entity that Impact Foundation would be investing into?*
Please describe the relationship between the companies listed:

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Please provide the following information for the exact legal entity that Impact Foundation would be investing into:
Company Employer Identification Number (EIN):*
If your company is located outside of the United States AND does not have an EIN, please write "International". If you are establishing a new company, please write "In Progress".
Please provide the "executive summary" of your company:*
Please provide a description of the products or services you provide:*
Please describe your revenue model (e.g. how you make money):*
Who are your main peers/competitors?*
Please describe your past milestones.*
Please describe your strategy for growth:*
Company Structure*
Company Website
Company Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Country of Operation*
Country of Registration*
For the entity that Impact Foundation would invest in.
Impact Countries (Select all that apply)*
Please select all countries where your product/service is available, or has an impact.
What industry do you operate in?*
Please select the best fit option from the drop down list.

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Impact Company Application

Please tell us about your company's social, environmental, and/or spiritual impact.
What type of impact are you focused on?*
Please select the best fit option from the drop down list.
Which UN Sustainable Development Goal are you most focused on?*
Please select the best fit option from the drop down list. For more detail on the UN's goals, visit their website: https://sdgs.un.org/goals
Please describe your company's social, environmental, or spiritual impact.*
What metrics do you track to know if you’re achieving those impact goals?*

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Impact Company Application

Please tell us about your company's social, environmental, and/or spiritual impact. We ask our portfolio companies to report the following metrics each year.
What was your total annual revenue in the last year?*
What was your total number of employees/workers (full- and part-time) in the last year?*
Do you currently have an environmental policy?*

YesNo
If you answered "Yes" to the above, please describe your environmental policy.
Do you currently have a spiritual integration plan?*

YesNo
If you answered "Yes" to the above, please describe your spiritual integration plan.

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Impact Company Application

Please tell us about the investment you are currently seeking.
What is the total amount of funding you are raising in this round?*
What is the investment amount you are seeking from Impact Foundation?*
Is 100% of capital due at signing or will capital be called over time? Please describe.
Please describe potential exit strategies from this investment.*
Type of Investment*

LoanConvertible LoanEquity
What will this investment be used for?*

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Impact Company Application

Please tell us about the investment you are currently seeking (Continued).
What percentage of the company will Impact Foundation own after the investment is completed? (write NA if this will be a loan, SAFE, or convertible loan)*
Please describe the voting rights that Impact Foundation will have after the investment (if any):*

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Impact Company Application

Please tell us about the investment you are currently seeking (Continued).
What are the repayment terms you seeking for this loan?*
At what frequency will repayments be made?*
For example: Monthly
Will the loan include a grace period?*

YesNo
If the loan includes a grace period, please describe:
For example: Grace period of 6 months after receipt
Will the loan be secured?*

YesNo
If the loan will be secured, please describe the collateral provided:

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Impact Company Application

Please tell us about the investment you are currently seeking (Continued).
Please describe conversion triggers.*
What is the valuation cap?*
What is the discount rate?*
Is there an interest rate?*
For example: Monthly
What are the repayment terms if the loan does not convert?
For example: This loan is secured by the land we are purchasing

Impact Company Application

Please acknowledge the following:
Please commit to update us immediately if any details change between the time you are submitting this form and when we initiate the investment.

This includes any changes made to your company, the terms of this investment, supporting documents or any other details in this application. If you do need to provide updates, please email Dan Voth at dan@impactfoundation.org or simply reply to the confirmation email you will receive after submitting the application.
Do you agree to this commitment?*

YesNo

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Impact Company Application

Please either upload a zipped folder here or send the documents to documents@impactfoundation.org
Please provide the documents for the exact legal entity that Impact Foundation would be investing into.

--

Documents Requested:
1. Business Plan/Marketing Plan
2. Biographies of Key Management
3. Articles of Organization/Incorporation
4. Term Sheet (if available)
5. Capital Structure: pre- and post-capital raise
6. Private Placement Memorandum (if available)
7. Transaction Documents: Subscription agreement, stock purchase agreement, loan agreement, and other (as applicable)
8. Bylaws or Operating Agreement
9. Prior years financials (3 years preferred) and financial projections
10. Wire instructions for your bank, including company's local address
11. ACH instructions for your bank
For secured debt (optional), please also provide:
1. Property address or description
2. Recent Title Insurance Report (if available)
3. Property Appraisal (if available)
Cancelof
Please also upload a high-resolution image of your company logo to Dropbox here (link also below).

https://www.dropbox.com/request/PXCAnh2UdElrUm49KNdZ

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Impact Company Application
That's everything we need at the moment - thank you!
Do you have any questions or comments for us?
Should be Empty:

Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Columbia
Comoros
Congo (Congo-Brazzaville)
Costa Rica
Croatia
Cuba
Cyprus
Czechia (Czech Republic)
C√¥te d'Ivoire
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (fmr. Swaziland)
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar (formerly Burma)
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Palestine State
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
United States of America
Uzbekistan
Vanuatu
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe

Impact Company Application

Thank you for getting in touch!

Impact Company Application

Impact Company Application

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Impact Company Application