Application

Applicant Information

* Indicates required field

Organization Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Website *

President/CEO/Executive Director *

President/CEO/Executive Director Email *

Phone Number *

Point of Contact Name *

First

Last

Title *

Point of Contact Email *

Point of Contact Phone Number *

Organization Information

Revenue *

Main Source of Funding *

Type of Organziation *

Number of Employees *

Number of People Served *

Percentage of Revenue to Operational Costs *

Communities Served *

Do you have volunteer opportunities available? *

Yes No Possibly

Major Supporters/Sponsors/Partners *

Please specify if you have a CBA relationship *

Please list your annual fundraising events (type/date): *

Please upload your Board of Directors list *

Max file size: 20MB

Please upload a proposal in 500 words or less, why you should be considered for the CBA Charitable Partner *

Max file size: 20MB

Please upload a current Form 990 *

Max file size: 20MB

Any additional materials that would support your proposal (videos, promotional materials, etc.) *

Max file size: 20MB

Submit