Charity Registration
Submit Application to become Eligible
Charity Name:
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Tax ID:
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Website:
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Mailing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Point of Contact:
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Point of Contact
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First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Tell Us Your Charity's Story: A 250-400 Word Narrative of Your Non-Profit's Purpose and Origin Story
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Upon Submission, our team will conduct a thorough analysis of your charity/non-profit organization. Please certify the following:
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I Certify that the Non-Profit has been in existence as a registered 501(c)3 for atleast 2 years.
I Certify that the Non-Profit is in Good Standing with the IRS and State of Maryland
I Certify that the funds received from ImpactClub Members will be used LOCALLY.
I Certify that should the Non-Profit 'win' an Event that I will return the next Quarter to update ImpactClub Members on how their funds Impacted the Community (Events are: Feb, May, Aug, Nov)
Additional Information (Optional): Please share any further details about your charity that you think would be helpful for us to consider during the application review process:
I Certify that the information provided above is accurate and true to the best of my knowledge.
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