New Agency or Program Application | United Way of Hancock County

AGENCY INFORMATION

Please submit agency information as attachments below.

1. IRS Nonprofit Determination Letter

One file only.
200 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

2. Articles of Incorporation

One file only.
200 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

3. Bylaws

One file only.
200 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

4. Signed Counter-Terrorism Compliance Form

One file only.
200 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

5. Nondiscrimination Policy

One file only.
200 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Agency Name

Agency Phone Number

Agency Mailing Address

Agency Website

Agency Mission Statement

Agency EIN

Executive Director's Name

Executive Director's Email

Current Board of Directors Roster

Board Chair's Name

Board Chair's Email Address

How long has your agency been operating?

PROGRAM INFORMATION

This information is needed for each program for which you are applying. If applying for multiple programs, please complete a separate application for each.

Which UWHC priority area does your program most closely align with?

Championing Children's Issues

Fighting Hunger

Promoting Safety & Health

Supporting Safe Housing

Fostering Financial Stability

Program Name

Total Funding Request (Please note, you will also need to supply financial documents prior to being approved to apply for United Way funding.)

Please provide a brief overview of what this program does and who it serves.

How does this program align with United Way of Hancock County's mission of measurably improving people's lives?

Please provide data from the most current year that show your program's impact on the individuals you serve.