Twelv Charitable Donation Program
Please review the worksheet and answer all applicable questions.
Email address *
Is your charity owned in whole or in part by a government official or government entity? *
Is the primary contact the same individual that is completing this form? If no, please provide the information of the person completing this form: *
How many years has your charity been in operation? *
How many volunteers and/or members does your charity have? *
Provide your charity's Street Address including City, State/Province, Postal Code and Country: *
In which geographies does your charity operate? *
Has your charity been the subject of or involved in any anti-corruption or anti-bribery investigation is the past five years? *
How does your charity raise money? *
How much money annually does your charity raise in funds for your cause? How is the moneyallocated? *
Provide your charity's web address: *
Provide your charity's legal name: *
Please identify any other names under which your charity operates globally (parent organization, subsidiaries, sister charities, affiliations, etc): *
Please provide your charity's primary contact person including name, title, phone number and email: *
What are the main differences between your charity and others supporting the same cause? *
Please provide an overview of your charity's mission and how it currently works to achieve its goals: *
Is there any pending or threatened material litigation against your charity (lawsuits, settlements, etc.)within the last 5 years? If yes, please explain. *
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