Nonprofit Questionnaire

Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Fax Number (Optional)

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name of the entity/ NGO*

Birth date:*

EIN #:*

Name of Board Members: A. President, B.Vice President, C. Treasurer, D. Secretary, E. General Board Members:*

How often will you have board meetings: Once a month or Quarterly?*

What is the background of each board member?*

Will you receive in-kind space or will you pay for space? If you have to pay, how much is the space monthly?*

Do you provide programs and services now free to the community?*

Only churches fill out the bottom of the Questionnaire.

Some questions may not apply. Answer to your best ability.

YesNo

What is your revenue?

What are your expenses?

What type of fundraisers do you have?

Do you have a website? What is your web address?

What programs and services do you offer the public currently?

Any other questions or comments?