Lift Up Carolinas Partnership Inquiry & Statement of Need
This form is designed to assess eligibility, mission alignment, and operational readiness prior to advancing partnership discussions.
Organization Information
Organization Name
*
Main Contact Name & Title
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Website / Social Media
Physical Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
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
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Geographic Areas Served
*
Legal & Organizational Status
Are you a registered 501(c)(3) nonprofit organization?
*
Yes
No
EIN Number
*
Upload IRS Determination Letter / Form 990
*
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Is your organization in good standing with state and federal requirements?
*
Yes
No
Does your organization carry liability insurance?
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Yes
No
Organizational Overview
Brief History of Your Organization
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Mission Statement
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Vision Statement
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Target Population Served
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Approximate number of individuals/families served annually
*
Partnership & Alignment
Describe the need for this partnership and how you envision working together, include anticipated duration
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Which Lift Up Carolinas pillar best aligns with your organization?
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We Feed
We Clothe
We Mentor
We Educate
Please explain your alignment
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What type of support or resources are you requesting?
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Is the request short-term, seasonal, or ongoing?
*
Please Select
Short-term
Seasonal
Ongoing
What geographic area or population will benefit from this partnership?
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Operations & Capacity
Do you have staff or volunteers available to pick up and distribute resources? Please describe how resources will be distributed.
*
Do you have storage capacity, if needed?
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Yes
No
Alignment & Affiliations
Are you affiliated with any advocacy, religious, or political organizations? If yes, please describe
Are there any restrictions on who your organization serves?
Have you previously partnered with Lift Up Carolinas?
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Yes
No
Data & Impact
Are you able to track and report distribution data and outcomes?
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Yes
No
If you answered yes to the question above, please explain.
Recognition & Communication
How will recipients know resources were provided by Lift Up Carolinas?
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How do you plan to acknowledge this partnership (e.g., social media, newsletters, events)?
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Are you willing to publicly recognize the partnership when appropriate?
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Yes
No
Final Acknowledgments
Submission of this form does not guarantee partnership approval. Lift Up Carolinas may request additional information before proceeding. Resources provided may not be resold or redistributed outside the agreed purpose.
I have read and agree to the above acknowledgments
*
I have read and agree to the above acknowledgments
Additional Information
Please share any additional information that would help us better understand your organization or this proposed partnership
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