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9: Proposed timetable for paynic,'t of requested funds from Greater Triangle Community Foundation: <br />Date, ,mount <br />•jam, y <br />10. Has your organization received an outside audit opinion within the last two years? <br />Yes No X If yes, please attach a copy of the audit opinion. <br />11. Tax Status <br />Tax - exempt charitable organization [501(c)(3)] <br />Other non - profit organization (specify status) <br />Affiliated with tax - exempt organization <br />Governmental tax - exempt unit <br />Unincorporated association , <br />_C,., Other (specify) _ .f�� ,.� �v,o(eo( �� x base 0).5 W1 c f' <br />Please attach a copy of your organization's tax status determination letter, A tax <br />exempt identification number is not sufficient. (Not applicable to governmental agencies.) <br />12. Is your staff: Paid or volunteer? <br />13, May the Foundation share your proposal with other potential funding sources? (The proposal <br />will not be made available to the public, but only to potential donors or grantmakers. Your answer <br />to this question will not affect the Foundation's consideration of your proposal.) <br />?�_ Yes No <br />14. Checklist. Have you: <br />Described the community need or opportunity the proposed activity is intended to <br />address? <br />✓ Thoroughly described the project or activity to be undertaken' <br />Determined the timetables for the project and for the requested funding? <br />Stated your organization's capability to undertake the proposed project, including <br />qualifications of personnel involved? <br />✓ Stated the specific objectives the program hopes to accomplish, in measurable terms <br />✓(for example, number of people served) if possible? <br />Discussed the relationship of the proposed project to other programs in the community <br />designed to meet the same or similar needs or opportunities 7 <br />Listed funds already committed for the project and from what sources? <br />Indicated how future funding will be obtained, if the project will be an ongoing one? <br />Enclosed 15 collated copies of : this Application form? <br />: the 3 page narrative proposal? <br />— : the proposed project budget? <br />current Board of Directors list, with affiliations? <br />Enclosed 1 copy each of : your organization's overall operating budget? <br />r : your organization's financial statements for the mi <br />recent fiscal year, with audit opinion, if available? <br />—►� : your IRS tax determination letter? <br />*PLEASE REMEMBER TO COLLATE ALL COPIES WITH THE APPLICATION FORM ON TOP. <br />15. I hereby certify that the applicant organization does not discriminate on the basis of <br />race, color, age, sex or national origin, ;r <br />Signature of Chief Officer of the Board <br />