2022 Pro Bono Clinic Legal Application

Full Name *

First Name Last Name

Title *

Organization Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Organization's Website *

Phone Number *

E-mail *

example@example.com

Summary of Organization's Services/Product *

Additional Organizational Information

Number of Employees *

Number of Independent Contractors *

Number of Volunteers *

Range of Compensation for Highest Paid Staff *

$0-$25,000 $25,000-$50,000 $50,000-$100,000 $100,000-$150,000 $150,000-$250,000 $250,000 and above

Tax-Exempt Status (if applicable)

501(c)(3) 501(c)(4) 501(c)(6) Not obtained/Not applicable Fiscal Agent

Ruling Date on Tax Exempt Status

Month Day Year

Organizational Structure *

Corporation Trust Unincorporated Association Sole Proprietor Partnership Limited Liability Company Nonprofit Corporation

Organization Formation Date *

Month Day Year

State(s) of Formation *

What Geographical Areas does your Organization Operate in? *

Organization's Fiscal Budget Information

Current Fiscal Year Budget *

Total Gross Receipt in Most Recently Completed Fiscal Year *

Annual Average Revenue *

Post Covid-19 Revenue *

Pay For Legal Services

Do you currently pay for Legal Services? *

Yes No

If Yes, Name of the Lawyer/Law Firm

If Yes, Services Provided

Current Fiscal Year Funds Budgeted for Legal Services *

Do you currently receive Pro Bono Legal Services? *

Yes No

If Yes, Name of the Lawyer/Law Firm

If Yes, Services Provided

Accounting Services

Do You Currently Pay for Accounting Services? *

Yes No

Current Fiscal Year Funds Budgeted For Accounting Services *

Legal Areas

Please place a checkmark next to each legal area with which you would like legal assistance. Approved nonprofits will be matched with an attorney from Stinson LLP and an attorney from the Association of Corporate Counsel to provide limited legal representation on nonprofit operational and governance issues.

Governance Legal Needs

Corporate Documents *

Articles Bylaws Board Makeup Meetings Voting Operational Documents None

For the boxes above, describe the legal need in more detail:

Board Policies *

Charters (Audit / Finance Committee, Compensation Committee, Governance Committee) Code of Professional and Ethical Practices and Conduct Adoption/Use of Agreements(Affiliate Agreements for Facilities/Staffing/Other Agreements with Directors/Officers/Staffers/Volunteers) None

For the boxes above, describe the legal need in more detail:

Liability of Directors & Officers (Fiduciary Duties and Indemnification) *

Yes No

For the boxes above, describe the legal need in more detail:

Operational Legal Needs

Contracts *

Yes No

If "Yes", describe the legal need in more detail and list all parties to the Contract (If "No", please put N/A): *

Employees and Staffing *

Classification as Employees, Contractors, Interns, Volunteers Compensation - Salary, Benefits, Retirement Plans Employee Contracts Federal, State, and Local Requirements Employee Policies Covid-19 Related Questions None

For the boxes above, describe the legal need in more detail:

Financial Statements (Review, Certification, Terminology, Rules) *

Yes No

For the boxes above, describe the legal need in more detail:

Funding *

Fundraising (Acknowledgement of Donor Contributions, Auctions, Board Member Expectations / Responsibilities, Commission Based Fundraising, Donor Intent, Gaming, Grants, Investments, IRS Issues, Legal Limitations/Requirements, Online Options/Issues (e-commerce / crowdfunding), Payment Methods, Pricing, Social Media and Apps, Sponsorships Versus Advertising, Standard Deduction Strategies, Standards Loans Solicitation - Limitations, State Registration (Missouri/Kansas) Covid-19 Related Questions None

For the boxes above, describe the legal need in more detail:

Intellectual Property *

Confidentiality Copyrights/Patents/Trade Names/Logos Creation/Control/Use Software and Other Licenses None

For the boxes above, describe the legal need in more detail:

Lobbying and Political Activities *

Yes No

For the boxes above, describe the legal need in more detail:

Real Estate (Leasing, Purchases, Sale Incentives, Covid-19 Questions) *

Yes No

For the boxes above, describe the legal need in more detail:

Restructuring or Terminating Your Organization *

Alliances and Joint Ventures (Contractual or separate entity - include parties to the contract below) Merging or Consolidating (include other entities below in other) Dissolution Distribution or Transfer of Assets Insolvency Strategies None

If "Yes", describe the legal need in more detail and list all parties to the Contract (If "No", please put N/A): *

Risk Management *

Contractual (Include parties to the contract in other below) Disaster Recovery and Emergency Response Plan Fraud and Illegal Activity (Cybersecurity) Insurance Legal Compliance Periodic Risk Assessments None

If "Yes", describe the legal need in more detail and list all parties to the Contract (If "No", please put N/A): *

Tax Matters for Nonprofit Organizations *

Applying for and Establishing Tax-Exempt Status Form 990 Maintaining Tax-Exempt Status (Organizational / Operational Tests) Property, Sales, and Use Tax Exemptions Unrelated Business Taxable Income (UBTI or UBIT) Covid-19 Related Questions None

For the boxes above, describe the legal need in more detail:

Tax Matters for For Profit Organizations *

Tax Planning Tax Elections Tax Forms Covid-19 Related Questions None

For the boxes above, describe the legal need in more detail:

Additional Information

Please provide any additional information you believe will be helpful:

How did you learn about this opportunity?

Signture Block

Please note that completion of this application does not guarantee acceptance into the Legal Clinic, nor does it ensure a meeting with an attorney. You will be notified at a later date if you are chosen to participate in the Legal Clinic.

If you are the accepted for participation in the Legal Clinic, be aware that your legal team may request written materials relevant to your organization, programs, board of directors, and specified legal needs, including, but not limited to: articles of incorporation/certificates of filing with secretary of state (if applicable) bylaws, newsletters, brochures, annual reports, tax-exemption letter from the IRS, and most recently filed IRS Form 990.

Your signature below authorizes the United Way of Greater Kansas City to release relevant documents and disclosures from its files to Stinson LLP and Association of Corporate Counsel Mid-America Chapter member attorneys, if and when accepted into the Legal Clinic.

The information given herein above is provided on behalf of the named organization as indicated above and is correct and true to the best of my knowledge. Legal Clinic organizers may verify the financial information provided and may request additional information.

Pro Bono Legal Clinic Application