Non-Profit Client Assessment Form
Please complete the following form to the best of your abilities. This will help in the assessment of potential funding opportunities as a client.
Email *
Name *
Email *
Phone number *
Mailing Address
 *
Website (If Available):
When was your organization established?
Where is your organization headquartered? (if different than address provided)
What type of Business Entity do you operate as?

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Do any of the owners identify with any of the following demographics? (Select all that apply)
Field of Work (Select all that apply):
What will you use the funds for?

Can you provide an overview of your organization, your mission, and your purpose?

What cities/states do you operate in?
Have you been awarded funding in the past
How many employees do you have?
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What is your annual fundraising target?
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How many years of financial statements do you have available?
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What types of services are you interested in? (check all that apply)
Are there any specific challenges or bottlenecks you're facing that may be hindering your organization's growth?
Additional Information, Comments, or Questions:
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