2018 Allocation Application
A Complete Application Includes:
o Completed Application
o Basic Information Form
o Program Narrative
o Program Budget
o Volunteer Needs Form

o Agency Commitment Form

o Suspension of Funds Agreement

o Copy of Most Recent Form 990

o Copy of IRS Tax Exemption Letter

o Copy of a Letter from the TN Secretary of State’s Division of Charitable Solicitations office that shows you are in good standing with state registration requirements.

o An updated portfolio on 211tn.org. Go to the homepage, click the Add Your Agency button to the right.

Fill out the following application by typing in relevant information. In addition, please attach the three requested documents listed above. Send your documents to cmcunitedway@gmail.com, and title your email “[Agency Name] UWCMC Application." Please call or email us with any questions.

Agency Name *
Your answer
Agency Contact Name *
Your answer
Agency Contact Email *
Your answer
Agency Contact Phone Number *
Your answer
Agency Contact Second Phone Number
Your answer
Check beside each eligibility criteria that applies to your agency *
Required
Mission Statement *
Your answer
List of Current Board Members *
Your answer
Please list all of your programs, and provide a brief (1-2 sentence) description of each. *
Your answer
Please list and describe partnerships you have with other agencies, organizations, government, etc.
Your answer
Please describe the program(s) for which you are requesting funds. Include the program’s services, goals, history, and information about the program’s success. Please describe how this program supports one of UWCMC’s four funding areas – education, income, health, or basic essentials. Please describe how you would use UWCMC funds. *
Your answer
Please include an itemized budget for the program(s). If you are requesting general operating funds that are not program specific, please include your organization’s operating budget (attach a copy in your email with other required documents).
Your answer
United Way of Coffee and Moore Counties fosters and manages a community volunteer force. Organizations and individuals go to UWCMC’s website to find volunteer opportunities in our community. Please provide a list of volunteer opportunities your agency may have (include volunteer opportunity, number of volunteers needed, and activity date).
Your answer
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