Thank you for your interest in applying for Fiscal Sponsorship under the Communities Foundation of Oklahoma (CFO). Effective November 4, 2015, CFO will offer this service only as it aligns with Model C, the pre-approved grant relationship, as defined by Colvin & Link (2005). Before applying, please give due consideration to the following: Does your project have a legitimate nonprofit purpose? Learn more: http://nonprofit.about.com/od/glossary/g/nonprofit.htm Would the IRS think this is a legitimate nonprofit activity if you applied for nonprofit status? Learn more: http://nonprofit.about.com/od/qathebasics/f/Needfortaxexemp.htm Does your project have enough traction to get funding for this idea? o Have you talked to potential funders? o Do you have a core of dedicated individual donors? Have you identified revenue sources and started exploring those pathways? o Remember projects under the Communities Foundation of Oklahoma umbrella are only able to solicit charitable donations in the State of Oklahoma. If you plan to seek funding from sources outside of Oklahoma, CFO will not be able to assist you with a Fiscal Sponsorship. Remember fiscal sponsorship is not a way around nonprofit requirements. Please complete the following information and return a signed copy of this document via email to Randy K. Macon, executive director, at rmacon@cfok.org Questions may be addressed via telephone conversation: 405.488.1450. The application begins on the next page. Reference Colvin, G. L., & Link, G. (2005). Fiscal sponsorship: 6 ways to do it right. San Francisco, CA: Study Center Press. 1. Name of Project 2. Principal Contact Name Address, City, State, ZIP Email Phone Number 3. How did you learn about Communities Foundation of Oklahoma? 4. Are you currently using another fiscal sponsor? Yes/No If yes, why do you want to change? 5. What is the legal status of this project? (Choose One) Sole Proprietorship 501(c)(3) Oklahoma nonprofit corporation that has applied for 501(c)(3) status Governmental Agency A fiscally sponsored project of another 501(c)(3) organization Other – please elaborate: 6. What is the charitable purpose/mission of your project? (Please explain in no more than 3 sentences.) 7. Project Location Please list all applicable Oklahoma Counties in which your project will provide services. 8. What is the main focus on your project? (Please check only the one category that most closely applies) Health Environment Animal Welfare Human Services Community Affairs Arts and Culture Education 9. Is this a project seeking incubation (looking to grow and then apply for unique 501(c)(3) status? Y/N If Yes, when do you anticipate applying for 501(c)(3) status? 10. Is this project the result of a single funder’s initiative? Y/N If Yes, please identify the funder and elaborate on the rationale behind the initiative 11. Is this project of limited duration? Y/N If Yes, within how many years do you expect to complete the project? 12. Current Project Assets (how much do you have now?) 13. Anticipated Annual Expenses (total amount here; attach full budget) 14. Anticipated Sources of Revenue Foundation Grants Government Grants Donations Events Fee For Service Other Anticipate Applying Applied for/Pending Committed Received $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 15. Advisory Committee (Minimum of 3 Required) Member 1 Name: Phone: Member 2 Name: Phone: Member 3 Name: Phone: Member 4 Name: Phone: Email: Email: Email: Email: 16. Staffing of Project How many of the following do you currently have? Employees: Volunteers: Independent Contractors: If not currently, do you expect to have employees/volunteers/ICs in the future?: 17. Briefly describe the history of this project. When did it begin and how? Describe current or future (aspirational) activities. Provide a description of, and number of, current (or future) participants/beneficiaries. 18. Briefly describe the work you have done to research, design, pilot test or demonstrate the project to date. Has the project already begun and activities taken place? Who else is doing this or similar work? What differentiates you and why do you think you will be successful? In what ways have key stakeholders been involved in the development of your program/model? Please attach an income-and-expense budget for your first year. Also, please attached evidence that your project has established an independent legal identity. Signature Date