Application for PAN Fiscal Sponsorship of Your Permaculture Project or Program
The Permaculture Association of the Northeast (PAN) seeks to help local, grassroots permaculture groups and practitioners be more effective.  One of the services we offer is fiscal sponsorship so that tax-deductible donations and grants can be applied to your work.

Step One:  Read about how PAN fiscal sponsorship works and make sure you feel your project is ELIGIBLE.
https://docs.google.com/document/d/1CF-gXRxaFoV44q0Ynb_YBCtqWGKvohNWhBtuR_Zk6-I/edit?usp=sharing

Step Two: Make sure that you (personally) or your organization is a PAN MEMBER in good standing.  http://northeastpermaculture.org/contact-us/

Step Three: Fill out this FORM and give us 7-10 days to send you the fiscal agreement to sign and then we'll be ready for your funds to flow through PAN! (If your timeline is urgent, please let us know in the comments below).

Step Four:  Make your $25 application fee payment via PayPal (http://northeastpermaculture.org/fiscal-sponsorship/fiscal-sponsorship-app-payment/) or mail us a check (http://northeastpermaculture.org/contact-us/).  After completing the form, you will receive a confirmation message with these links.

Sign in to Google to save your progress. Learn more
Email *
Contact Person First Name *
Contact Person Last Name *
Contact Person email *
Contact Person phone number *
Organization or Business *
i.e. who would PAN write the check to?
Our project/business legal structure is... *
EIN or SSN *
We will need EIN or SSN to issue a Form 1099 to comply with IRS requirements
Mailing Address *
To which PAN will send the funds (street/pobox/city/state/zip)
I/we are a PAN member in good standing? *
Project Name (if applicable)
How will the funds you receive be used? *
PAN is responsible for ensuring fiscally-sponsored work is consistent with the charitable "education" mission of our work.
When do you anticipate funds will be received by PAN? *
Approximately when do think you will want the funds disbursed? *
What is the end date of the project or anticipated last disbursement date? *
Unless otherwise specified, MOUs expire 12/31 each year.
What is the estimated TOTAL amount of funds that will be passed through PAN during this fiscal sponsorship? *
How do you expect the funds to be sent to PAN? *
Required
Do you agree to use the funds only for the stated purpose (consistent with PAN's mission to increase access to education and resources) *
Do you agree to send a summary of how the funds were used to PAN by January 15 for any monies spent in the prior calendar year? *
(this is so that PAN can maintain the integrity of its 501c3 status with the IRS)
Do you agree not to use the term "scholarships" in your promotional materials for events and projects that will use these funds? *
Which method will you use to send us the $25 application fee? *
Required
Other Comments or Notes
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms