Share the Plate

Your name: *

Your email address: *

Your phone number: *

Date of this application: *

Your connection to this organization: *

Name of organization: *

Organization address: *

Organization website: *

Executive Director's name: *

Organization phone: *

501(c)(3) status: *

Yes

No

501(c) Verification: *

How may we verify your 501(c)3 status?

List Board Members: *

How is this organization connected to UUCP?: *

How does this organization's values and mission reflect those of UUCP? Are there UUCP members who donate, work with, receive services, serve on staff or board? Does this organization interact with some aspect of UUCP's programming?

What is the impact of this organization?: *

Explain the impact of this organization with specific examples and numbers on who is served, and how this is achieved.

Financial Information: *

Provide specific information about the organization's financial status, including
current budget, size of programs, and revenue sources.

Administrative Overhead: *

Use Of Funds: *

Reason for Support: *

Unitarian Universalist Congregation of Phoenix

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