Work with US information questionnaire
Welcome and thanks in advance for taking the time to provide some brief information about your organization. These answers will help us help you!
Email address *
Name *
Your answer
Organization Name *
Your answer
Mission Statement
Your answer
What is the currently going on in your community that your organization wants to change? *
Your answer
What is the future of your community if nothing changes? *
Your answer
What resources (relationships, partners, locations) does your program need to succeed? *
Your answer
What are the actions/activities that your organization or program does? (please list out) *
Your answer
What are the outcomes that your organization or program intends to change from the actions/activities listed above? *
Your answer
Are there modifiers that can make the actions/activities or outcomes change faster?
What is your estimated annual program budget? (please provide an upper limit)
Your answer
Have you secured funding from a funder currently or in the past?
Is there anything else you would like to share with us?
Your answer
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