Annual Operating Budget Support Request- Tourism Based

Nonprofit Funding Request

Tourism Based Request
Deadline: January 31, 2025 at 5:00pm

The Town of Kernersville considers funding nonprofits based on the services they provide to the citizens of Kernersville. Funds may also be provided to nonprofits based on the amount of travel and tourism they bring to the Town.
To Save Your Application
If at any time you'd like to leave this form and save it in progress, please click on the next button and exit your browser. To resume your submission at a later time, return to the form via the link contained in your registration email. (YOUR BROWSER MUST BE ENABLED TO ACCEPT COOKIES. DATA IS SAVED LOCALLY IN YOUR BROWSER UNITL SUBMITTED)

Does your program operate in Kernersville?*

YesNo
Only nonprofits located in Kernersville are eligible for funding from the Town of Kernersville

1. Online Application
Organization Name*
Is the name above the same as it appears on the IRS Letter of Determination?*

YesNo
If not, please explain.
Tax Status?*

501(C)(3)Other
Tax ID (EIN)*
If not 501(c)(3), what is your tax status?
Does your organization have a Charitable Solicitation License from the State of North Carolina.*

YesNo
Charitable Solicitation License Expiration Date?
Year Organization Incorporated*
Physical Address*

Street Address

Street Address Line 2

CityState

Zip Code
Upload IRS determination letter

Upload a File
*You may skip this step if the Town has your letter on file Cancelof
Upload most recent 990

Upload a File

Cancelof
To Save Your Application
If at any time you'd like to leave this form and save it in progress, please click on the next button and exit your browser. To resume your submission at a later time, return to the form via the link contained in your registration email. (YOUR BROWSER MUST BE ENABLED TO ACCEPT COOKIES. DATA IS SAVED LOCALLY IN YOUR BROWSER UNITL SUBMITTED)

2. Contact Information
Contact/ Chief Operating Officer*

First NameLast Name
Contact Title*
How long have you been in this position with this organization?*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Does Your Organization have a Board of Directors?

YesNo
How many directors serve on your Board currently?
Please upload a list of your current Board of Directors

Browse Files

Cancelof
To Save Your Application
If at any time you'd like to leave this form and save it in progress, please click on the next button and exit your browser. To resume your submission at a later time, return to the form via the link contained in your registration email. (YOUR BROWSER MUST BE ENABLED TO ACCEPT COOKIES. DATA IS SAVED LOCALLY IN YOUR BROWSER UNITL SUBMITTED)

3. Financial Information
Operating Budget $ (Organization)*
Fiscal Year Starting *
Fiscal Year Ending *
Sources of Income:
Government %*
Individual Contributions %*
Foundation Grants %*
Fees / Earned Income %*
Corporate Grants %*
Other %*
Past recipient of Town of Kernersville funding?*

YesNo
Amount of Town funding requested in FY 2023-2024
To Save Your Application
If at any time you'd like to leave this form and save it in progress, please click on the next button and exit your browser. To resume your submission at a later time, return to the form via the link contained in your registration email. (YOUR BROWSER MUST BE ENABLED TO ACCEPT COOKIES. DATA IS SAVED LOCALLY IN YOUR BROWSER UNITL SUBMITTED)

Tourism Information
Number of visitors in 2024*
Number of visitors 2024*
Does this organization bring tourist from outside Kernersville?*
Does the organization bring tourist from outside Kernersville

YesNo
If so, approximately how many?
Give a general listing of where tourist are from:
Number of advertising packets/info packets sent out in 2024
Number of Welcome Center/other venues where info packets are located
Number of community events in 2024
Average Attendance at program/events
Number of tour groups/school groups that toured last year
Amount ($) spent directly on advertising in 2024
Amount ($) spent with publications outside of Kernersville
Number of Volunteers in 2024
Number of Volunteers in 2024
Estimated # of volunteer hours in 2024
Estimated # of volunteer hours in 2024
List of special events held in 2024 (include any joint events with other organization in Town)
To Save Your Application
If at any time you'd like to leave this form and save it in progress, please click on the next button and exit your browser. To resume your submission at a later time, return to the form via the link contained in your registration email. (YOUR BROWSER MUST BE ENABLED TO ACCEPT COOKIES. DATA IS SAVED LOCALLY IN YOUR BROWSER UNITL SUBMITTED)

4. Funding Information
How will Town funds be used?*

Specific ProjectOperating Support
Amount of this request?*
How will Town funds be used (please use this space to explain)*

0/200
To Save Your Application
If at any time you'd like to leave this form and save it in progress, please click on the next button and exit your browser. To resume your submission at a later time, return to the form from the link contained in your registration email. (YOUR BROWSER MUST BE ENABLED TO ACCEPT COOKIES. DATA IS SAVED LOCALLY IN YOUR BROWSER UNITL SUBMITTED)

5. Narrative

This section must be completed with a file upload
Please upload a seperate document for the following request:

We want to learn:
- Your mission
- The strategies used to achieve the mission that are measurably effective
- The organization has the capacity to be successful and sustainable
- What programs are you offering (any new programs)
- Are you getting feedback from your clients/customers and how are you using that feedback
- What is your positive impact on our community
You may upload a word document here that includes your mission statement and purpose, organizational qualifications, history of accomplishments, and governances. If you work with other organizations, describe your work with other agencies. Please limit this document to 500 words.

Browse Files

Cancelof
To Save Your Application
If at any time you'd like to leave this form and save it in progress, please click on the next button and exit your browser. To resume your submission at a later time, return to the form via the link contained in your registration email. (YOUR BROWSER MUST BE ENABLED TO ACCEPT COOKIES. DATA IS SAVED LOCALLY IN YOUR BROWSER UNITL SUBMITTED)

5. Narrative
Please list any other financial or in-kind allowances received from the Town
If there is any other information that you believe the Town needs to know, please upload that information here.

Browse Files

Cancelof
To Save Your Application
If at any time you'd like to leave this form and save it in progress, please click on the next button and exit your browser. To resume your submission at a later time, return to the form via the link contained in your registration email. (YOUR BROWSER MUST BE ENABLED TO ACCEPT COOKIES. DATA IS SAVED LOCALLY IN YOUR BROWSER UNITL SUBMITTED)

6. Grant Submission
*

I agree that the insertion of data into the following fields constitutes an electronic signature.
I understand that if I receive funding from the Town of Kernersville I will be required to submit funding reports as required by the Town
*

I understand that by submitting this application I certify that all statements and representations are true and correct. I understand that I may be held civilly and/or criminally liable under federal or state law for knowingly making false or fraudulent statements. I grant the Town of Kernersville or its agent, authority to verify records, public, and private, for the purpose of evaluating this request for financial assistance, and to physically inspect any funded project. Information provided to and obtained by the Town of Kernersville may be subject to public disclosure during deliberations of the Town of Kernersville at public meetings, in minutes of public meetings or under the North Carolina Public Records Act.
*

I certify that I am authorized by the Executive Director and / or Board of Directors to submit this proposal on behalf of the organization.
Name
Title
Date
Should be Empty:

Nonprofit Funding Request

1. Online Application

2. Contact Information

3. Financial Information

Tourism Information

4. Funding Information

5. Narrative

5. Narrative

6. Grant Submission