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Community Information Form
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* Use whole numbers, not percentages. The "Race & Ethnicity" totals should equal the total number of people you have on your staff and board and the total number of people you expect to serve
* Use the "additional" rows to add any identities that are relevant to the people in your organization and/or to show how your leadership has lived experience with the issues you work address (e.g. "experience with homelessness," "formerly incarcerated," or "English language learners"); if individuals decline to self-identify, you can also use these rows to indicate "did not specify"
* The "People Served" column will almost always be an estimate; if you're requesting funds for a specific project, it should reflect the demographics of the people you expect to serve with that project. Otherwise, it should reflect the total number and demographics of the people your organization serves in a year
* The "Volunteers" column is optional; organizations without paid staff are particularly encouraged to provide this data
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Organization Name (from IRS Letter):Paid StaffBoardPeople ServedNon-Board Volunteers (optional)
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REQUIREDREQUIRED: Race & Ethnicity
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African, African American, or Black
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Asian or Pacific Islander
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European American or White
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Latina, Latino, or Latinx
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Middle Eastern or North African
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Native American, American Indian, or Alaska Native
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Multi-Racial
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Additional (optional - describe):
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Additional (optional - describe):
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Total:00
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REQUIRED: Additional Information
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Immigrant or Refugee
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Living with a Disability (incl. chronic and mental illness)
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Low-Income (<200% federal poverty level)
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OPTIONALOPTIONAL Additional Information
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Lesbian, Gay, Bisexual, or Queer
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Transgender or Nonbinary
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Women or Girls
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Living in a Rural Area (10+ miles from city of 40,000)
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Additional (describe):
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Additional (describe):
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Additional (describe):
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Additional (describe):
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Additional comments or clarifications about the demographic information you've provided, including how you've arrived at any estimates (optional)
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If you have questions about completing this form, please contact Leann Do: ldo@collinsfoundation.org
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