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501C3 Intake Form
Jen Williams International
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(and intend to exceed your expectations!)
How did you hear of Jen Williams?
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I'm an Existing Client
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Referree's Name
Is this for a 501C3 Reinstatement?
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No
Yes
Full Name
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First Name
Last Name
TItle
Phone Number
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Area Code
Phone Number
E-mail
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ORGANIZATION INFORMATION
Organization Name
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Address
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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
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Azerbaijan
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Belgium
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Benin
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Burkina Faso
Burundi
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Canada
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Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
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Cook Islands
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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
What COUNTY? (not country)
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Primary Type of Organization
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Religious (church, mosque, synagogue, temple, etc)
Religious ministry (not a church, etc)
Charitable
Educational (not a school)
School
Hospital; Medical Center
Amateur Sports
Literary
Child Cruelty Prevention
Animal Cruelty Prevention
Public Safety Testing
Other
Website address (if any)
CORPORATE DOCUMENT INFORMATION
Is organization incorporated?
*
Yes. Will provide a copy of FILED Articles
No, I need this
If yes, upload FILED Articles here
Upload a File
Cancel
of
Does organization have an EIN?
*
Yes, number is below
No, I need this
The EIN is
If no EIN, what is your Social Security #? (Required by U.S. Patriot Act to get a new EIN from IRS)
Does organization have bylaws?
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Yes. Will provide a copy
No, I need this
If yes, upload here
Upload a File
Cancel
of
If ordering Bylaws below, what is your Mission Statement? (1 or 2 sentences only please)
OFFICER INFORMATION
The President can't be Secretary or Treasurer, but Secretary and Treasurer can be same person. If unknown at this time, please write TBD (to be determined)
Name & Address of President
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Name & Address of Secretary
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Name & Address of Treasurer
*
DIRECTOR INFORMATION
Board should be an odd number in case of tie vote (minimum 3, no maximum) with the majority unrelated by blood or marriage. All 3 officers above can also be the Board members below. Board members do not have to be U. S. citizens or reside in the same state as the organization, but should be at least 18 years old due to their fiduciary service. If unknown at this time, please write TBD (to be determined)
Name & Address of Chairman (if different from President or write SAME)
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Name & Address of Director #2 (if different from Secretary or write SAME)
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Name & Address of Director #3 (if different from Treasurer or write SAME)
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Names & Addresses of additional Directors (if any)
ACTIVITY & OPERATION INFORMATION
If possible, use a BRIEF "who", "what", "when", "where", "why" and "how" format.
Describe what your organization does (or intends to do)
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GRANTS
Jen Williams no longer write grants. However, we can help you find grants. Please note that search results are not guaranteed. We also cannot guarantee you will receive any funds from a grantor.
Do a grant search?
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Yes, please!
Not at this time, thanks.
If yes, what key words should we use to search for grants regarding your nonprofit's needs and/or activities?
What is your preferred method of payment?
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Cash App
Zelle
Other
Request for FREE Consultation
Phone Call or Zoom Meeting appointments available in your time zone.
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I don't need either at this time
Which time zone are you in?
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Appointment Request
TERMS OF SERVICE & PRIVACY POLICY
Both policies are at jenwilliamsintl.com
By checking this box and electronically signing below, I have read the Terms of Service and Privacy Policy, and agree to same.
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I AGREE
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Thank you!
If you requested an appointment above, we will answer any questions you may have at that time. If no appointment was requested above, we will contact you if we have any questions or need additional information. In the meantime, a file will be opened and an invoice sent to get started.
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