3rd Cycle 501cTECH Small Nonprofit Transformation Application

Small Nonprofit Transformation Application (Third Cycle)
PART 1: ELIGIBILITY
To qualify for the Small Nonprofit Transformation Initiative, your organization must meet the following requirements. Please check each box to verify your eligibility.*

My organization is a 501 (c) 3 charitable organization (as defined by the Internal Revenue Service), other than: churches or organizations whose primary mission is to promote a religion; private school, colleges or universities; nonprofit hospitals or cooperative hospital service organizations; and governmental units.My organization can demonstrate fiscal responsibility, which is defined as adherence to generally accepted accounting standards.My organization is inclusive and embraces diversity; does not discriminate in service delivery and employment on any basis including ethnicity, gender, sexual orientation or religion.My organization is based, or has a chapter in, the Washington Metropolitan area which is defined as the District of Columbia, suburban Maryland or suburban Virginia.My organization has an annual operating budget under $1 millionMy organization has 10 or fewer fulltime staff membersMy organization provides services to communities located in Wards 7 and 8
PART 2: ORGANIZATIONAL INFORMATION
Organization:*
EIN #:*
Website url:*
Organization Address (street address, city, state, zip):*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact person:*

First NameLast Name
Contact's title:*
Contact's phone number:*

Area CodePhone Number
Contact's email:*
Primary point of contact (if different)

First NameLast Name
POC email:
PART 3: ORGANIZATIONAL BACKGROUND
Mission (Limit 100 words):*

0/100
Services your nonprofit provides (Limit 200 words):*

0/200
Please provide an estimate of how many people your organization serves in a year: *

0/200
Briefly describe the types of clients your organization serves. (Limit 250 words):*

0/250
Any other historical background information that you feel is relevant and important in understanding your application? (Limit 200 words) *

0/200
PART 4: IMPACT AND REPLICABILITY

Through this initiative 501cTECH and its corporate partners are building capacity and using the power of technology to change lives.
Explain some of the current technology challenges you experience. How do these challenges affect your day to day work. How is your mission is impacted.*

0/300
How can 501cTECH build technology capacity at your organization and help deliver or improve its services. (250- character limit)*

0/250
Given unlimited resources, give one example of how you'd see your organization leveraging technology to promote your mission.*

0/400
PART 5: TECHNOLOGY DISCOVERY
HARDWARE
Computers
Number of PC desktops
General age of PC desktops
Number of PC laptops
General age of PC laptops
Number of Apple computers
General age of Apple computers
Servers
Number of servers
General age of servers
SOFTWARE
Email
Email provider (e.g. Exchange, Google Apps, Network Solutions):
How do you access email? (e.g. log into gmail or open Outlook):
Productivity Software
Productivity software (i.e. Microsoft Office 2007, Open Office, Google Docs):
Software location
Database
Database (e.g. Access, Excel, FileMaker Pro, Salesforce, CiviCRM):
Software location
Accounting Software
Accounting software (e.g., Quickbooks 2012 for Nonprofits):
Software location
Thank you. We look forward to reviewing your application.
Should be Empty:

Small Nonprofit Transformation Application (Third Cycle)

PART 1: ELIGIBILITY

PART 2: ORGANIZATIONAL INFORMATION

PART 3: ORGANIZATIONAL BACKGROUND

PART 4: IMPACT AND REPLICABILITY

PART 5: TECHNOLOGY DISCOVERY

Thank you. We look forward to reviewing your application.