DISBURSEMENT FORM – 501C3
Please choose a disbursement option below:
Please send collected funds by ACH to a US Bank:
Account Name: 2000045457700
Account Number: 2000045457700
Routing Number: 063107513
Bank Name: Wachovia Bank
Primary Account contact person: Philocles Desir
Contact address: PO Box 153012
Contact phone: (239) 214-4922
Secondary Account contact person:
Contact address:
Contact phone:
Please send collected funds by check:
Check should be made out to: All the Children Are Children, Inc.
Check should be sent to (address):P.O. 153012 Cape Coral, Fl 33915
If you are fundraising for your projects on GlobalGiving UK, please provide wire transfer details
so ourGGUK team can send over your funds:N/A
Account Name:
Account Number:
Account contact person: Contact phone:
Contact address:
Bank Name: Bank Address:
Bank City: Bank State:
SWIFT code:
Organizational Information:
1. Name and Title (of applicant): _All the Children Are Children, Inc.
2. Name and Title of GlobalGiving contact (Who will manage your project communication
onGlobalGiving?): Kristin E. Smith
3. Email (of GlobalGiving contact): ksmith@globagiving.org
4. Web Address:
4. Official name of Organization: ______________
5. Address of Organization: 1023 15th Street NW, Twelfth Floor
Washington, DC 20005
6. Telephone: ( 202) 232-5784. 7. Fax: (202) 232-0534
APPENDIX I:
GLOBALGIVING NON-DISCRIMINATION POLICY
___We__(Organization name) All the Children Are Children, (ATCAC)___________
does not discriminate in its staff, board, volunteers, volunteer committees, or recipients
of services on the basis of a person’s race, political orientation, religion, gender, sexual
orientation, age, national origin, ethnicity, ancestry, marital status, veteran status, or
mental or physical disability or any other status prohibited by applicable law.
Organization Name: All the Children Are Children, Inc.
(Please write out organization’s name)
Signature: _______________________________ Name: ________________
Title: ____________________________________ Date: _________________
APPENDIX II:
GLOBALGIVING ANTI-TERROR CERTIFICATION
By signing and submitting this application, the prospective recipient provides the
certification set out below:
1. The Recipient, to the best of its current knowledge, did not provide, within the
previous ten years, and will take all reasonable steps to ensure that it does not and will
not knowingly provide, material support or resources to any individual or entity that
commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or
has committed, attempted to commit, facilitated, or participated in terrorist acts, as that
term is defined inparagraph 3.
2. The following steps may enable the Recipient to comply with its obligations under
paragraph 1:
a. Before providing any material support or resources to an individual or entity, the
Recipient
will verify that the individual or entity does not (i) appear on the master list of Specially
Designated Nationals and Blocked Persons, which list is maintained by the U.S.
Treasury’s
Office of Foreign Assets Control (OFAC) and is available online at OFAC’s website :
http://www.treas.gov/offices/eotffc/ofac/sdn/t11sdn.pdf, or (ii) is not included in any
supplementary information concerning prohibited individuals or entities that may be
provided by
GGF to the Recipient.
b. Before providing any material support or resources to an individual or entity, the
Recipient
also will verify that the individual or entity has not been designated by the United
Nations
Security (UNSC) sanctions committee established under UNSC Resolution 1267 (1999)
(the
“1267 Committee”) [individuals and entities linked to the Taliban, Usama bin Laden, or
the Al
Qaida Organization]. To determine whether there has been a published designation of
an
individual or entity by the 1267 Committee, the Recipient should refer to the
consolidated list
available online at the Committee’s website:
http://www.un.org/Docs/sc/committees/1267/1267ListEng.htm.
c. Before providing any material support or resources to an individual or entity, the
Recipient
will consider all information about that individual or entity of which it is aware and all
public
information that is reasonably available to it or of which it should be aware.
d. The Recipient also will implement reasonable monitoring and oversight procedures to
safeguard against assistance being diverted to support terrorist activity.
3. For purposes of this Certification.
a. “Material support and resources” means currency or monetary instruments or
financial
securities, financial services, lodging, training, expert advice or assistance, safehouses,
false
documentation or identification, communications equipment, facilities, weapons, lethal
substances, explosives, personnel, transportation, and other physical assets, except
medicine or
religious materials.”
b. “Terrorist act” means- (i) an act prohibited pursuant to one of the 12 United Nations
Conventions and Protocols related to terrorism (see UN terrorism conventions Internet
site:
http://untreaty.un.org/English/Terrorism.asp); or (ii) an act of premeditated, politically
motivated
violence perpetrated against noncombatant targets by subnational groups or
clandestine agents;
or (iii) any other act intended to cause death or serious bodily injury to a civilian, or to
any other
person not taking an active part in hostilities in a situation of armed conflict, when the
purpose of
such act, by its nature or context, is to intimidate a population, or to compel a
government or an
international organization to do or to abstain from doing any act.
c. “Entity” means a partnership, association, corporation, or other organization, group or
subgroup.
d. References in this Certification to the provision of material support and resources
shall not be
deemed to include the furnishing of GGF funds or GGF-financed commodities to the
ultimate
beneficiaries of GGF assistance, such as recipients of food, medical care, microenterprise loans,
shelter, etc., unless the Recipient has reason to believe that one or more of these
beneficiaries
commits, attempts to commit, advocates, facilitates, or participates in terrorist acts, or
has
committed, attempted to commit, facilitated or participated in terrorist acts.
e. The Recipient’s obligations under paragraph 1 are not applicable to the
procurement of goods and/or services by the Recipient that are acquired in the ordinary
course of
business through contract or purchase, e.g., utilities, rents, office supplies, gasoline,
etc., unless
the Recipient has reason to believe that a vendor or supplier of such goods and
services commits,
attempts to commit, advocates, facilitates, or participates in terrorist acts, or has
committed,
attempted to commit, facilitated or participated in terrorist acts.
This Certification is an express term and condition of any agreement issued as a result
of this application, and any violation of it shall be grounds for unilateral termination of
the agreement by GGF prior to the end of its term.
Organization Name: All the Children Are Children, Inc (ATCAC)
(Please write out organization’s name)
Signature: ________________________Name:___________________
Title: _____________________________Date:_________________
APPENDIX III:
GLOBALGIVING COMMUNITY TERMS AND CONDITIONS
1. Fees –There is no set-up fee or monthly fee to post your project on
GlobalGiving.com.
GlobalGiving retains a flat 15% fee from each donation received online or by check to
support organizations in their fundraising efforts. The donor has the option of making a
separate 15% donation to the GlobalGiving Foundation so that 100% of the donation
amount will be granted to your charity.
2. Disbursement – Approximately monthly, GGF will forward funds to your organization.
For international wire transfers, GGF does not disburse less than $250. GGF will
provide the amount to be allocated to each project you have posted at GG.org.
3. Use of Funds and Duration of Project on GG.org - You commit that funds disbursed
for projects will be used only for activities described on the corresponding project page
at GG.org and any of its sister sites. Projects that continue to receive donations, but
have not reached 100% of total funds requested, will remain on GG.org until completely
funded, and you may request that a project be deactivated at any time. Projects
receiving no donations after one year or failing to report for two consecutive quarters will
be marked as ‘retired’ and removed from the site. 4. Multiple Projects – Once you have
been approved, you may post multiple projects to the website.
5. Copyright - GGF shares the copyright with you to the project content and other media
(pictures, video, etc.) uploaded to GG.org and will attribute content used to your
organization.
6. Use of Logo and Name - GGF may use your name and/or your logo for display
purposes on GG.org and in marketing efforts designed to obtain donors for your project.
GGF will not use your name or logo for other purposes without first obtaining your
consent.
7. Reporting - You agree to provide brief quarterly updates for each project you have
posted on GG.org. GGF will display updates on your project page and will e-mail them
to donors.
8. Donor Privacy – GGF will forward name and e-mail information for each donor to your
project that has chosen to allow GGF to forward this information. Address is not
available.
You commit to not redistribute to any third party the donor information you receive from
GGF.
Notwithstanding the above, GG retains the right to change these terms and conditions
and will notify signatory within 30 days of such changes.
I have read, understand, and agree to comply with the above GGF Community Terms
and Conditions.
Organization Name: All the Children Are Children, (ATCAC)
Signature: _______________________________ Name:
Title: ____________________________________ Date:_______
Board of Directors
Philocles Desir
Frantz Pierre
Moise Anelus
Geranie Delva
Genevieve Francois
Keteline Jeune