Date of Application:

Legal name of organization or community applying (Should be same as IRS 501(c) (3) determination letter if nonprofit applicant):

Organization Executive Director/President/CEO

Salutation:

Mr. Mrs. Ms.

Name:

Title:

Organization:

Business Mailing Address:

City:

State:

Zip:

Work Phone Number:

Home Phone Number:

Fax:

Email:

Website:

Board member or other executive staff member.

Salutation:

Mr. Mrs. Ms.

Name:

Title:

Organization:

Business Mailing Address:

City:

State:

Zip:

Work Phone Number:

Home Phone Number:

Fax:

Email:

Website:

If applicable, date organization was established:

Tax ID Number:

Does your organization or community currently have an endowment fund:

Yes No

If yes, is it your intent to transfer all or a portion of those assets to the Grand Rapids Community Foundation to establish your fund:

All Portion Don't Know

Do you have mechanisms in place through which you can market your endowment fund i.e. database, newsletter or website:

Yes No

Do your current fundraising efforts sufficiently support your programs:

Yes No

Does your donor base have the means and interest to contribute to an endowment fund in addition to their regular support:

Yes No N/A

Describe your organization's level of planned giving marketing ability and support for your donor constituency: (150 words)

If you have an endowment, who is currently responsible for investment management and oversight: (150 words)

Optional: Investment Returns for Last Quarter:

Optional: Investment Returns for Last 1 Year:

Optional: Investment Returns for Last 3 Years:

Optional: Investment Returns for Last 5 Years:

After you click submit, a new window will display your answers. Please print for your records.
The above information will be kept confidential.